| NPI | 1396288742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN K WILSON Sole Member 614-235-9552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OH 017498) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment | |
| Enumeration Date | 2016-12-01 |
| Last Update Date | 2016-12-01 |