| NPI | 1114001997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN A LUNA Owner 419-331-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OH 30020543) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2008-04-04 |