| NPI | 1578833174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK A STRAKA Owner 614-267-0385 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Additional Taxonomies | 1223P0106X Dentist Oral and Maxillofacial Pathology |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2012-01-12 |