| NPI | 1831633718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN WEICHERT Receptionist 734-728-5424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MI 15106) |
| Enumeration Date | 2016-12-12 |
| Last Update Date | 2016-12-12 |