| NPI | 1164066320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD MOSHER Owner 330-904-7753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-10-31 |
| Last Update Date | 2020-09-17 |