| 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 |