| NPI | 1467616292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANISSA DAVID Office Manager 313-843-4003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 018429) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2008-07-10 |