| NPI | 1205200763 |
|---|---|
| Doing Business As | WILLOW CREEK FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | ERIC SHANE DUNN President 513-523-7541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30.022862) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2015-11-20 |
| Last Update Date | 2015-11-20 |