| NPI | 1730797556 |
|---|---|
| Doing Business As | AESTHETIC DENTAL CLINIQUE |
| Entity Type | Organization |
| Authorized Contact | DIANE INGRAM HINES Dentist 313-207-5945 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-07-17 |
| Last Update Date | 2020-07-17 |