| NPI | 1538126263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA SHANK Book Keeper 313-565-9118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MI 8357) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: MI 9563) |
| 1223E0200X Dentist, Endodontics (Licence: MI 9366) | |
| 1223E0200X Dentist, Endodontics (Licence: MI 10546) | |
| 1223E0200X Dentist, Endodontics (Licence: MI 14484) | |
| 1223E0200X Dentist, Endodontics (Licence: MI 16152) | |
| 1223E0200X Dentist, Endodontics (Licence: MI 13637) | |
| 1223E0200X Dentist, Endodontics (Licence: MI 18227) | |
| 1223E0200X Dentist, Endodontics (Licence: MI 17362) | |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2020-08-07 |