| NPI | 1568595973 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE PHILIP MERCADO President 248-625-5000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901013545) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-08-22 |