| NPI | 1033228713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE ELAINE STINE Business Manager/Member 419-626-4696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30-020781) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2014-03-21 |