| NPI | 1316253149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STAFANI SANDOVAL Insurance Specialist 440-356-2089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 022436) |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2021-07-28 |