| NPI | 1326258476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENDERSON ANDREW JOHNSON President Owner 216-566-7770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30-017934) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |