| NPI | 1902389984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAMI JANDALI Owner 248-626-6526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2018-09-14 |
| Last Update Date | 2021-03-04 |