| NPI | 1396623740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE M JANE President 248-471-1555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2025-08-25 |
| Last Update Date | 2025-08-25 |