NPI | 1225347081 |
---|---|
Entity Type | Organization |
Authorized Contact | EARL K. BOGROW President Owner 248-827-1900 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MI L1376041) |
Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: MI L1376041) |
Enumeration Date | 2010-09-28 |
Last Update Date | 2023-09-25 |