| NPI | 1457616500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACLYN SMITH Program Director 313-505-6665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MI 2902016147) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2012-07-05 |