| NPI | 1497077630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | C PATRICK GRAY Owner/President 810-732-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 122300000x) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MI 1223s0112x) |
| Enumeration Date | 2010-02-15 |
| Last Update Date | 2010-02-15 |