| NPI | 1811506629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY FRANCES JONES Office Manager 248-348-7997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2020-07-28 |