| NPI | 1477615979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA L COFFEY Office Manager 513-772-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30013080) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30021079) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2007-07-25 |