| NPI | 1629329198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY W KOSMAN Owner 440-988-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: OH 35099912) |
| Enumeration Date | 2012-09-25 |
| Last Update Date | 2012-09-25 |