| NPI | 1477040087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAPHAEL R. PUTRUS President, Chief Orthodontist 586-999-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MI 2901022120) |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2018-09-08 |