| NPI | 1417300617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE WORKMAN Analyst, Revenue Cycle Management 440-241-1931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TN 3831) |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2018-12-03 |