| NPI | 1295133460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY PHIPPS Tx Coordinator 586-323-1600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MI 2901019237) |
| Enumeration Date | 2014-12-19 |
| Last Update Date | 2014-12-19 |