| NPI | 1467600528 |
|---|---|
| Doing Business As | PROFESSIONAL DENTAL OF CLARKSTON |
| Entity Type | Organization |
| Authorized Contact | BRIAN P. DAVIDSON President / Dentist 248-620-6200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901018686) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901019449) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2008-09-03 |