| NPI | 1962902312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES C. ROSS President 248-513-4367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MI 2901013573) |
| Enumeration Date | 2018-02-12 |
| Last Update Date | 2018-08-15 |