| NPI | 1578666442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN BYRON MIKESELL President Member 419-738-6944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: OH 30012922) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: OH 30021456) |
| 1223E0200X Dentist, Endodontics (Licence: OH 30021501) | |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2020-08-22 |