NPI | 1306047600 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN V. GAUL President 248-547-8833 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: MI 2901009537) |
Enumeration Date | 2007-05-31 |
Last Update Date | 2020-08-22 |