| NPI | 1194029736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW S MATTA Sole Owner 330-533-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS036253) |
| Enumeration Date | 2010-12-22 |
| Last Update Date | 2010-12-22 |