| NPI | 1861269755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP LEVY Chairman 313-745-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| 1223G0001X Dentist, General Practice | |
| Enumeration Date | 2023-12-11 |
| Last Update Date | 2023-12-11 |