| NPI | 1609262443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LYNN ZOLL Owner 419-474-0733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: OH 18423) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: OH 022954) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2015-04-08 |