| NPI | 1548444102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON M GOLNICK Pediatric Dentist 313-292-7777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MI 2901016484) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2007-12-19 |