| NPI | 1477814697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN MIRFENDERESKI Owner 740-454-9961 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30-021794) |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2012-06-05 |