| NPI | 1245509710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLE LAYNE Office Manager 734-994-1040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MI 2901018321) |
| Enumeration Date | 2011-12-29 |
| Last Update Date | 2011-12-29 |