NPI | 1700053634 |
---|---|
Entity Type | Organization |
Authorized Contact | BARRY ALLEN MENTZEL President 586-772-1880 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MI M10005) |
Enumeration Date | 2008-05-09 |
Last Update Date | 2008-05-09 |