| NPI | 1164515714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY ANDREW FORDE President 440-842-2203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OH 30014287) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-08-22 |