| NPI | 1528338704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY M. LAWRENCE President 419-473-2707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OH 3016301) |
| Enumeration Date | 2012-01-05 |
| Last Update Date | 2012-01-05 |