| NPI | 1306149430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON DOUGLAS PAULUS Dentist 330-833-4746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OH 30.014457) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: OH 30.021964) |
| Enumeration Date | 2010-12-12 |
| Last Update Date | 2010-12-12 |