| NPI | 1023149390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY ALLEN LABISHAK Dentist 740-454-4112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OH 20416) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |