| NPI | 1427185776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD CARL BOLTEN President 248-673-7026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901012575) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2020-08-22 |