| NPI | 1093097495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY M JUDIS Owner 614-409-9404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 19680) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 022588) |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2011-09-13 |