| NPI | 1396240354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER SUZANNE CHASSE Insurance Coordinator 248-219-7722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MI 273504940) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2018-03-29 |