| NPI | 1629245170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL JOLLY Pc President 614-473-0400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OH 30021038) |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2012-11-07 |