| NPI | 1720660251 |
|---|---|
| Doing Business As | N/A |
| Entity Type | Organization |
| Authorized Contact | JOHN TALBOTT BARTA Dentist 810-691-2233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-04-23 |
| Last Update Date | 2021-04-23 |