| NPI | 1891817631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK GERALD FRIZZO Member 248-855-3435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 14232) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2020-08-22 |