| NPI | 1447227301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | C. RANDALL DOAN President 330-364-8665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2011-02-08 |