| NPI | 1407130719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMILLE KOLANSKI Mananger/Rdh 330-920-8060 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 19182) |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2011-10-05 |