| NPI | 1710495874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAITLIN CORUM Assistant/Front Desk 313-386-0570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: MI 2901022062) |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2018-09-27 |