| NPI | 1487961611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES PATRICK BECKWELL Owner 586-777-6440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MI 2901014857) |
| Enumeration Date | 2010-09-09 |
| Last Update Date | 2010-09-09 |