| NPI | 1417240847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONNIE L ANDERSON President 937-390-6616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 15020) |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2011-05-18 |