| NPI | 1598951055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK S MEDEL Owner 989-723-3882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MI MM13787) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2007-12-21 |