| NPI | 1215477336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRA TOR Part Owner 440-885-1980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 30-016808) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 30-024155) |
| Enumeration Date | 2017-03-08 |
| Last Update Date | 2017-03-08 |