| NPI | 1396379012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLY WARDEN Owner 248-245-4716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-03-03 |
| Last Update Date | 2020-03-03 |