| NPI | 1093266777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CRAIG SIVIK General Dentist, President, Owner 440-992-3146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2024-10-03 |