| NPI | 1528955127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE SIKORA Owner 248-264-3922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2025-06-18 |
| Last Update Date | 2025-07-30 |