| NPI | 1023557162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY S EVANS Office Manager 740-607-0442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30022618) |
| Enumeration Date | 2017-02-22 |
| Last Update Date | 2017-02-22 |