| NPI | 1962783399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK KOENEN SETTER Owner 810-987-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MI MS012152) |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2011-08-30 |