| NPI | 1225427370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHIL GOODMAN Orthodontist 937-938-6433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 15975) |
| Enumeration Date | 2015-01-13 |
| Last Update Date | 2015-01-13 |