| NPI | 1366478828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTY LYNN FAKADEJ Office Manager 216-663-1967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 15639) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2008-06-25 |