| NPI | 1366957862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGG S RESNICK Owner 989-354-4884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: MI 2901013806) |
| Enumeration Date | 2017-12-06 |
| Last Update Date | 2017-12-06 |