| NPI | 1205262045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW MICHAEL KILLGORE Owner President 513-739-9117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30022880) |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2013-09-25 |