| NPI | 1437323904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MICHAEL SUSHYNSKI Member 810-733-5310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MI 2901019960) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2014-01-01 |