| NPI | 1669649026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUANN THOMPSON Office Manager 810-987-7224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 10502) |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2008-05-14 |