| NPI | 1548369564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ANTHONY IACOBELLI President 440-845-7300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: OH 17096) |
| 122400000X Denturist | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2023-06-07 |