| NPI | 1104226174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | S. RICHARD SCOTT Orthodontist 937-644-8830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 18834) |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2014-08-27 |