NPI | 1225141948 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN SELBY BROKLOFF Owner 330-668-1001 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OH 20982) |
Enumeration Date | 2006-08-16 |
Last Update Date | 2020-08-22 |