| NPI | 1356066062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY R CREEK Director 330-224-9528 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-10-05 |
| Last Update Date | 2022-10-05 |