| NPI | 1255547543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENE HENDERSON Dentist 440-323-3339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 14676) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2008-10-07 |