| NPI | 1376879742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAVIS D PHILLIPS Office Manager 313-535-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901014040) |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2009-10-20 |