| NPI | 1356577498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARNELL KAIGLER Periodontist 313-871-0436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MI 2901018534) |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2010-12-27 |