| NPI | 1639186257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN SUZETTE DUBOSE CEO/President 513-851-0044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 19505) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2020-08-22 |