| NPI | 1417243965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOLORES JENNY BARAN Detist/Owner 248-548-1440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MI 2901015013) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2011-06-23 |