| NPI | 1306911631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NELSON M PETROV Owner Dentist 440-366-5530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: 20368) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: 12537) |
| 1223G0001X Dentist, General Practice (Licence: 12537) | |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2008-07-23 |