| NPI | 1578781464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD WENNERSTEN President 734-668-9988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901015708) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |