| NPI | 1295103729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MARIE MOTYL Owner 248-540-3494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901020555) |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2015-09-15 |