| NPI | 1477663557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN ERIC MATHENY Dentist 614-860-0065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30-021764) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |