| NPI | 1487848693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY DAVID OLEJKO Owner 740-368-5566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OH 30-01-5199) |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2007-12-27 |