| NPI | 1346982147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN GUSFA President 313-565-5350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2022-04-12 |