| NPI | 1881562635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY ANN POHLMAN Member 810-227-6995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2025-10-24 |
| Last Update Date | 2026-04-20 |