| NPI | 1821112467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD EDWARD STEFAN President 248-852-6400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 012502) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 012557) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2020-08-22 |