| NPI | 1336166289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEL T GRASSETTE Insurance COO Rdinator 614-885-3339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2012-03-13 |