| NPI | 1134630163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAKIA THOMAS Manager 216-395-7336 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: OH 30.019830) |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2017-10-17 |