| NPI | 1497822167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN JOE HALLGARTH President 330-650-1119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 30-01-9885) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2020-08-22 |