| NPI | 1760633747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREL OWENS President 313-273-0640 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 11444) |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2008-10-08 |