| NPI | 1083108435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEONA KIMMEL Office Manager 440-937-8878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30.020075) |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2018-06-19 |