| NPI | 1992754022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY REIDER President Midwestern Clinical Ops. 313-582-8150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: n/a) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2017-05-08 |