| NPI | 1477727600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN LEWIS Office Manager 586-268-1840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 8375) |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2008-04-18 |