| NPI | 1720779390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK WOOD Partner 248-770-0411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 1223P0300X Dentist, Periodontics | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2023-05-16 |
| Last Update Date | 2023-05-16 |