| NPI | 1366155202 |
|---|---|
| Doing Business As | DETROIT DENTAL SPA |
| Entity Type | Organization |
| Authorized Contact | BAN NACY Owner/Dentist 832-419-7998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-01-05 |
| Last Update Date | 2023-03-15 |