| NPI | 1528008042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH TYLER SEMINARA Credentialing Specialist 734-459-0326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2024-11-18 |