| NPI | 1205233673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY J. ELLISON Admin/Director Of Finance 614-293-2189 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2014-12-01 |