| NPI | 1386829059 |
|---|---|
| Other Name | SUPERTEETH |
| Entity Type | Organization |
| Authorized Contact | HANLEY LAWRENCE KAISER President 586-759-5353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901009847) |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2007-12-31 |