| NPI | 1669897807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS KWONG Owner 269-366-0882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MI 2901020356) |
| Enumeration Date | 2014-02-25 |
| Last Update Date | 2014-02-25 |