| NPI | 1093817835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH C WELSH Owner 740-593-8530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 14320) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 20749) |
| 122300000X Dentist (Licence: OH 17938) | |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2018-10-11 |