| NPI | 1760888036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL COFFMAN Office Manager 734-973-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 15028) |
| Enumeration Date | 2014-11-13 |
| Last Update Date | 2014-11-13 |