| NPI | 1427433234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT RONALD SANDERS Dentist 614-348-5639 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: OH BS18281) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2015-07-22 |