| NPI | 1073664074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD P LEWIS President 216-261-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OH 30-015177) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-08-22 |