| NPI | 1851750608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA D. HALL Dental Hygienist/Office Administrat 248-763-3384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MI 2902003560) |
| Enumeration Date | 2016-02-22 |
| Last Update Date | 2016-02-22 |