| NPI | 1609233345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW HORNE Owner 734-274-9226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO DEN.00202691) |
| Enumeration Date | 2016-01-26 |
| Last Update Date | 2016-09-16 |