| NPI | 1891748422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN B FOLBE Owner 586-573-6677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 9870) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 16341) |
| 1223G0001X Dentist, General Practice (Licence: MI 2901018141) | |
| 1223G0001X Dentist, General Practice (Licence: MI 2901019030) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2020-08-22 |