| NPI | 1275030686 |
|---|---|
| Doing Business As | SC |
| Entity Type | Organization |
| Authorized Contact | ANGEL RENEE BRADSHAW Director Of Operations 330-469-0487 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30.022821) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2018-04-11 |