| NPI | 1063865848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY MOLLICA Office Manager 3307-256-0182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30.24802) |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2016-07-18 |