| NPI | 1093266777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CRAIG SIVIK General Dentist, President, Owner 440-992-3146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30-022904) |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2016-10-18 |