| NPI | 1083153985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY W. KOSMAN Owner 440-934-2626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OH 30020221) |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2017-02-13 |