| NPI | 1639413933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA HYDE Manager 313-863-2800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: MI 2901007381) |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2013-02-07 |