| NPI | 1518073659 |
|---|---|
| Doing Business As | FOUNTAIN SQUARE COSMETIC DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | ANDREW J HARRIS Vice President 513-621-1432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 18174) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 14977) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2020-08-22 |