| NPI | 1871970178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL MASHNI Owner/Dentist 248-686-6305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MI 18210) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: MI 18210) |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2015-05-06 |