| NPI | 1972548063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD FELLER Owner/President 734-528-9306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 15161) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2020-08-22 |