| NPI | 1386974145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD L FREEMAN Owner/Dentist 419-281-0760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 16353) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WV 21399) |
| 1223P0300X Dentist, Periodontics (Licence: OH 022342) | |
| Enumeration Date | 2009-12-30 |
| Last Update Date | 2009-12-30 |