| NPI | 1548872518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDY S ACOSTA Practice Development Manager 734-525-6100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health |
| Enumeration Date | 2020-08-20 |
| Last Update Date | 2020-08-20 |