| NPI | 1639577141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY B. WAITE President 330-607-8098 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 20821) |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2015-05-08 |