| NPI | 1306050794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH M SIROCKY General Dentist Owner Of Practice 440-238-2298 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30015213) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2020-08-22 |