| NPI | 1649371121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEWART S MARKOFSKY President 313-381-0343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 12305) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 12551) |
| 122300000X Dentist (Licence: MI 12122) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2020-08-22 |