| NPI | 1881643096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MORGAN Administrative Director 313-582-8150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: n/a) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2020-08-22 |