| NPI | 1497718647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH A VELICK Dentist/President 248-477-5888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 13011) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2020-08-22 |