| NPI | 1427247758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHADOWS O BEDELL Dentist 313-892-9148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 12360) |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2007-11-02 |