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 |