| NPI | 1417439696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN DIESING PERRETT Owner 248-851-6446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901014703) |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2018-09-04 |