| NPI | 1972583334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG A FEDORE President 517-337-0351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 13143) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2007-10-03 |