| NPI | 1063549236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK L BILLY President 330-792-2501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: OH 204E0000X) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2012-01-23 |