NPI | 1518165141 |
---|---|
Former Legal Business Name | NANSTON DENTAL GROUP, P.C. |
Entity Type | Organization |
Authorized Contact | JONATHAN C JOHNSON Founder 248-203-1100 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: GA DN006556) |
Enumeration Date | 2007-07-05 |
Last Update Date | 2011-11-15 |