| NPI | 1841505088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGG DAVID BOBIER President 248-656-8880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: MI 2901013708) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: MI 2901013708) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2010-08-12 |