| NPI | 1437546439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREL NATHANIEL OWENS President 313-273-0640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MI 2901011444) |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2015-04-17 |