| NPI | 1386391456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN K MOELLER Associate Director 614-293-5288 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality |
| Enumeration Date | 2022-03-08 |
| Last Update Date | 2022-05-16 |