| NPI | 1003034596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE ANN SILK Owner 440-248-6699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 16492) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 16523) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2015-04-20 |