| NPI | 1790868024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLENE KAY HANNA Office Manager 989-631-2900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 08577) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-08-22 |