| NPI | 1316419674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE TEIFER Owner 734-454-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2018-12-27 |
| Last Update Date | 2018-12-27 |