| NPI | 1538425954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS G THOMPSON Owner/Dentist 248-642-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 16969) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2012-04-10 |