| NPI | 1528413812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK R NYKIEL Owner 248-642-2115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: MI 2901020214) |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2024-10-01 |