| NPI | 1386890903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP HENRY IFFLAND President 330-478-0019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: OH 30.017097) |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2008-08-14 |