| NPI | 1679808042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA LARKINS Vice President Of Michigan 313-745-2117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2009-10-02 |
| Last Update Date | 2009-10-02 |