| NPI | 1902810237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY LONGAS Office Manager 248-645-3700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901011431) |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2020-08-22 |