| NPI | 1215100698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN E CROCK President 740-344-3372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2008-04-08 |