| NPI | 1780169086 |
|---|---|
| Doing Business As | KELLER PARKWAY DENTAL |
| Entity Type | Organization |
| Authorized Contact | DEEPA VENUGOPAL CEO 313-549-1401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2018-10-02 |
| Last Update Date | 2018-10-02 |