| NPI | 1366630014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD ARTHUR RAABE Owner 330-836-9341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: OH 30013959) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2007-10-09 |