| NPI | 1356496236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY ALLEN DEBEVOISE President 740-522-3161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: OH 30-014354) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2020-08-22 |