| NPI | 1508136516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN CHARLES BACARELLA President 734-243-0440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 012448) |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2012-01-06 |