| NPI | 1174503056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY JOSEPH MILLER President 330-425-0912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30016426) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30016458) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2020-08-22 |