| NPI | 1689043192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELIA YVETTE KENNEBREW HORTON Periodontist/Owner 248-552-1195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MI D2901015296) |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2015-09-15 |