| NPI | 1417012774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATTY BAKER Administrator 248-681-8100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MI 09568) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-08-22 |