| NPI | 1497061899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN T CROWLEY Dentist 734-646-9210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 00010997) |
| Enumeration Date | 2010-08-23 |
| Last Update Date | 2013-04-17 |