| NPI | 1497900302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE K ELLIOTT Office Manager 586-756-5880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MI 4963) |
| Enumeration Date | 2008-11-19 |
| Last Update Date | 2008-11-19 |