NPI | 1801970124 |
---|---|
Entity Type | Organization |
Authorized Contact | KELLY RATOWSKI Director 248-703-2003 |
Organization Subpart ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
Additional Taxonomies | 122300000X Dentist |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MI 830190) | |
Enumeration Date | 2006-10-24 |
Last Update Date | 2024-03-06 |