| NPI | 1962523001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID P SMITH Supervising Dentist 810-985-3729 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MI 015451) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-08-22 |