| NPI | 1962960096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS MICHAEL KACHOREK Owner 586-263-1241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2021-02-25 |