| NPI | 1922753227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS MICHAEL FREDAL Dr. / Owner 586-544-4440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2022-02-15 |
| Last Update Date | 2022-02-16 |