| NPI | 1649371543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BRUCE MACINTOSH President 248-642-2115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: MI 007491) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2008-01-03 |