| NPI | 1861530024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY MICHAEL BERMAN Vice President 734-697-4400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 1223P0300X Dentist Periodontics |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2007-09-13 |