| NPI | 1023532421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAIL SANDISH Admin Asst 216-485-5788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: OH 30-025210) |
| 1223E0200X Dentist Endodontics (Licence: OH 30-025207) | |
| 1223G0001X Dentist General Practice (Licence: OH 30-015265) | |
| Enumeration Date | 2017-07-28 |
| Last Update Date | 2021-05-26 |