| NPI | 1689111213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT CLIFFORD HOOD President 5172-656-9369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MI 17442) |
| Enumeration Date | 2017-01-20 |
| Last Update Date | 2017-01-20 |