| NPI | 1659689750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES PATRICK BECKWELL Owner 586-566-9519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901014857) |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2010-09-23 |