| NPI | 1568636660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN HERBERT GERSTENMAIER Owner President 330-867-5688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30014537) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MI 2901010057) |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2008-04-18 |