| NPI | 1639506280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA R OTTAWAY Dentist/Owner 313-886-9355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MI 016554) |
| Enumeration Date | 2013-09-27 |
| Last Update Date | 2013-09-27 |