| NPI | 1447461280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS S KELLY President 330-342-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30-01-9809) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30-01-9108) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |