| NPI | 1538360078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIE RUSS Office Manager 614-864-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 14389) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2014-10-16 |