| Organization Name: | DR. DAVID BASCH & DR. ALAN WIDLANSKY, PLLC DBA DNA MEDICAL CENTER |
| NPI Number: | 1922449776 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ALAN WIDLANSKY (PHYSICIAN) |
| Mailing Address: | 486 W Huron St Pontiac |
| State: | MI US |
| Postal Code: | 483411602 |
| Phone Number: | 2483359970 |
| Fax Number: | |
| NPI Enumeration Date: | 07/09/2013 |
| NPI Last Update Date: | 07/09/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 5101013808 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |