| NPI | 1912379751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONG CHOI Regional Dental Director 517-780-5760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: MI 2901014477) |
| Additional Taxonomies | 251S00000X (Licence: MI 2901014477) |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2015-10-20 |