| NPI | 1497873558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS JEROME KARDYNAL Owner Dentist 586-978-0015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901017281) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |