| NPI | 1487105771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY V GRUELLE Owner 859-391-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 30 015943) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 30 023642) |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2016-10-20 |