| NPI | 1922206507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMAR MOKHAYESH Dentist 248-548-1777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901017682) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2020-08-22 |