| NPI | 1376044909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER L BULTHUIS Dentist 734-422-1332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: MI 13246) |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2018-02-28 |