| NPI | 1497463046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON SHOUKRI Orthodontist 734-975-8730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-11-14 |
| Last Update Date | 2022-11-14 |