| NPI | 1407450877 |
|---|---|
| Doing Business As | SOUTH LYON DENTAL |
| Entity Type | Organization |
| Authorized Contact | RANDALL LOREN SHAW Owner 248-931-1151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health |
| Enumeration Date | 2020-11-25 |
| Last Update Date | 2020-11-25 |