| NPI | 1205326162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | R CHRISTOPHER CARSON Owner 440-543-1234 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 20891) |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2018-05-22 |