| NPI | 1639395288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRIS EDWARD NICHOLAS VP 419-475-3494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 20078) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2020-08-22 |