| NPI | 1679777171 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | SIRISHA NEMALLAPUDI Dentist 248-813-7700  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901017598)  | 
| Enumeration Date | 2007-06-11 | 
| Last Update Date | 2024-12-27 |