| NPI | 1841415031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD ANTHONY MATO Owner 810-355-3500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901017938) |
| Enumeration Date | 2007-04-15 |
| Last Update Date | 2020-08-22 |