| NPI | 1013450014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY S LEE Owner 740-432-8768 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: OH 30.021802) |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2024-09-25 |