| NPI | 1326404583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES ROBERT VERBANIC Dentist 330-872-5737 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: OH 15223) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OH 30.15233) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OH 30.024283) | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2016-01-04 |
| Last Update Date | 2019-01-10 |