| NPI | 1619391984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTINE BEATTY Front Desk 937-233-6500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 20761) |
| Enumeration Date | 2014-02-07 |
| Last Update Date | 2014-02-07 |