| NPI | 1205974078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES P FENELL Owner 216-291-9473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 14662) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2020-08-22 |