| NPI | 1417903725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH ALLEN HUDSON Executive Director/CEO 248-530-9812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MI 015250) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2020-08-22 |