| NPI | 1619348653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW STEPHEN HOLPUCH Officer 330-527-4313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: OH 30-024225) |
| Enumeration Date | 2015-10-16 |
| Last Update Date | 2015-10-16 |