| NPI | 1467608182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM J CIARAVINO Doctor/President 313-885-5150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 67430) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 16101) |
| 1223G0001X Dentist, General Practice (Licence: MI 16108) | |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2008-08-13 |