| NPI | 1740676451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT G HUBBARD Co Owner 248-853-9400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 12903) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 20209) |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2015-04-09 |