| NPI | 1689257800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE WILKINSON Dental Administrative Assisitant 810-734-2347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-05-05 |
| Last Update Date | 2021-05-05 |