| NPI | 1831424548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK MENDIOLA Dentist/Owner 248-210-8049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.026772) |
| Enumeration Date | 2009-10-14 |
| Last Update Date | 2009-10-14 |