| NPI | 1558442202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRITIDA TUSHAR PATEL Secretary 248-879-5858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901015961) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901015929) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2008-01-31 |