| NPI | 1083839765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER JEREMY MADDOX Owner 513-574-7511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30020431) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2020-08-22 |