| NPI | 1932292216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JOSEPH DEPORRE President 248-656-2244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 13866) |
| Enumeration Date | 2006-10-01 |
| Last Update Date | 2020-08-22 |