| NPI | 1235325499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY BRYAN President 586-778-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck | |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2013-10-01 |