| NPI | 1568684140 |
|---|---|
| Former Legal Business Name | YELLOW SPRINGS DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | JOHN T RUSSELL Clinician 937-767-7731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OH 30.013562) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2010-05-19 |