| NPI | 1083919252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW S MATTA Member 330-533-3400 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30022469) |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2011-01-20 |