| NPI | 1902736572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID AARON FENTON Medical Director 734-678-8141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 122300000X Dentist |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 124Q00000X Dental Hygienist | |
| 207L00000X Anesthesiology | |
| 207T00000X Neurological Surgery | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2026-05-22 |
| Last Update Date | 2026-05-22 |