| NPI | 1831382407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY DOLL A DOLL Recp. 517-322-8061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA 18754) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 18503) |
| 122300000X Dentist (Licence: MI 18854) | |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2007-08-27 |