| NPI | 1790748762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH RUNNELS BOZELL President 734-451-0995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901010640) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2020-08-22 |