| NPI | 1629133814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW B WADE President 614-878-7887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: OH 20722) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-08-22 |