| NPI | 1316110984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLAN DALE PADBURY Periodontist 517-784-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MI 1223P0300X) |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2008-04-03 |