| NPI | 1497115877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI A THOMAS Managing Officer 313-576-2554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MI 2901017876) |
| Enumeration Date | 2016-02-29 |
| Last Update Date | 2016-02-29 |