| NPI | 1053558601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE HARITONOVICH Dentist / Vice President 440-779-7292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OH 18653) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: OH 13759) |
| Enumeration Date | 2009-01-18 |
| Last Update Date | 2009-01-18 |