| NPI | 1912255928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL STEVEN HENDERSON Vice President 248-431-4954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MI 2901017049) |
| Enumeration Date | 2012-08-22 |
| Last Update Date | 2012-08-22 |