NPI | 1417072612 |
---|---|
Entity Type | Organization |
Authorized Contact | DORIS J ALLEN Director 734-998-9640 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Additional Taxonomies | 1223G0001X Dentist, General Practice |
1223P0300X Dentist, Periodontics | |
124Q00000X Dental Hygienist | |
126800000X Dental Assistant | |
Enumeration Date | 2007-03-20 |
Last Update Date | 2020-08-22 |