| NPI | 1740214683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK EDWARD WOLOWIEC President/Owner/Dentist 248-855-0824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 16156) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 8407) |
| 1223G0001X Dentist, General Practice (Licence: MI 8413) | |
| 1223G0001X Dentist, General Practice (Licence: MI 014173) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2018-03-23 |