| NPI | 1720415714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH CUEVAS Office Manager 313-554-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MI 2901018176) |
| Enumeration Date | 2013-10-04 |
| Last Update Date | 2013-10-04 |