| NPI | 1336497924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ALAN FRIEDRICH Business Manager 216-701-0609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 21030) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 20236) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2012-08-29 |