| NPI | 1306011549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELODY D. MINSTER Office Manager 248-478-0831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901019678) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901019402) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2008-04-29 |