| NPI | 1366500118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE KATHLEEN LEZOTTE Owner 248-623-4600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901017712) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2016-08-25 |