| NPI | 1891100681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN THOMAS SHAUGHNESSY Manager 989-430-7219 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NY 056944) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2014-06-30 |