| NPI | 1104987163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD L FOGEL President 440-323-2665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 30-015746) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2020-08-22 |