| NPI | 1932643111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHAEL GALE-MARIE KOPSCH Office Manager 248-848-1126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901016619) |
| Enumeration Date | 2016-12-07 |
| Last Update Date | 2016-12-07 |