NPI | 1285040980 |
---|---|
Other Name | TED V TSO |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: OH 30.027372) |
Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: MA DL12713) |
1223P0700X Dentist, Prosthodontics (Licence: CA DDS100123) | |
Enumeration Date | 2014-07-02 |
Last Update Date | 2024-04-04 |