| NPI | 1053597930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY LAYMASTER Financial Manager 937-748-8814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2014-01-09 |