| NPI | 1346428026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY JOHNSTON President 586-268-5520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MI 13303) |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2008-02-05 |