| NPI | 1629287255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ANTHONY EBY President 734-243-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MI 2901018199) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2008-06-25 |