| NPI | 1194888271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN EDWARD CASTEEL Owner 513-541-1941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 19142) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: OH 30111549) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-08-22 |