| NPI | 1427459049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI ARNOLD Office COO Rdinator 248-673-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MI 12916) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MI 20149) |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2014-09-15 |