| NPI | 1225199839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEN ARTHUR MCMURRAY President 419-562-0203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 16773) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 21265) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2020-08-22 |