| NPI | 1437892940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWLAT HASSO Business Owner 734-241-6166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2022-04-14 |
| Last Update Date | 2022-04-14 |