| NPI | 1245391424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN DAVOL CHAPMAN Administrator 216-368-0592 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: OH 30-00150) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30-18847) |
| 1223G0001X Dentist, General Practice (Licence: OH 30-20215) | |
| 1223P0300X Dentist, Periodontics (Licence: OH 30-022076) | |
| 1223P0700X Dentist, Prosthodontics (Licence: OH 30-00194) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 30-00149) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 30-021785) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2020-08-22 |