| NPI | 1619141256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOREEN L ZAFFER Manager 248-624-3010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901016989) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MI 291016802) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2013-03-20 |