| NPI | 1659875144 |
|---|---|
| Doing Business As | MICHIGAN GUM DOCS |
| Entity Type | Organization |
| Authorized Contact | OLEG UNPRICED KRIVICHKIN Doctor 248-327-1919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MI 21098) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2020-07-22 |