| NPI | 1386741494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP D. O'NIEL President 248-649-2868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MI 2901011105) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |