| NPI | 1306470596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAMNOON SIDDIQUI President 313-565-0880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2020-02-26 |