| NPI | 1487152799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY WASSON Receptionist 513-398-8777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: OH 20317) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: OH 20317) |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2018-02-01 |