| NPI | 1356782155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL MICHAEL FLYNN Owner 517-321-3236 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: MI 2901011737) |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2014-02-03 |