| NPI | 1215142617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN SCOTT JOHNSON Partner 740-654-3660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 21893) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 20694) |
| 1223G0001X Dentist, General Practice (Licence: OH 17640) | |
| 1223G0001X Dentist, General Practice (Licence: OH 14102) | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2020-08-22 |