| NPI | 1508131160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNELIES S CORNISH Owner 734-426-8360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2012-03-15 |
| Last Update Date | 2025-02-18 |