| NPI | 1730256710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE SHEILS VERGELDT President 248-646-1381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 16594) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2020-08-22 |