| NPI | 1194254607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW VANZANTEN Dentist 740-574-1515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental (Licence: OH 30025116) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2024-10-29 |