| NPI | 1689824369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA FARENGER Office Manager 586-412-1144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MI 18743) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2008-09-30 |