| NPI | 1427595164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SERGIO MAURICIO MOELLER ZEVALLOS Dentist 734-662-7874 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: MI 18235) |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2017-01-19 |