| NPI | 1588962351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALVIN DABOUL Dr 248-629-1830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| 261QD0000X Clinic/Center, Dental | |
| Enumeration Date | 2011-03-03 |
| Last Update Date | 2021-09-16 |