| NPI | 1265522262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY SIMONELLI Office Manager 269-323-1527 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2015-06-02 |