| NPI | 1356361257 |
|---|---|
| Doing Business As | PSOTA FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | JONATHAN JAY KLINEMAN Owner 440-888-6783 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 14616) |
| 122300000X Dentist (Licence: OH 21039) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2015-04-07 |