| NPI | 1396800058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISHAQ GHALEB ALI President 313-870-9423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: MI 2901018920) |
| Enumeration Date | 2006-12-23 |
| Last Update Date | 2020-08-22 |