| NPI | 1306008792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM RUSSELL HUBBELL CEO 810-987-9666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901011497) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MI 2901011497) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2008-06-27 |