| NPI | 1093588964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WALTER BALLRICK Partner 440-331-5450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2023-11-02 |
| Last Update Date | 2023-11-02 |