| NPI | 1568556595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA L. INGEBRAND Office Manager 419-524-7409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 18512) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |