| NPI | 1104063379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | K. BRAD KNAPP President/Owner 216-241-6104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: OH 30-017067) |
| Enumeration Date | 2009-01-09 |
| Last Update Date | 2009-01-09 |