| NPI | 1558703876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE DANIELLE TEIFER Owner 248-579-4404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2013-07-29 |