| NPI | 1720529621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH J HARDEN General Dentist 313-871-4405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 13687) |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2017-12-08 |