| NPI | 1649340480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY M GIBBS President 614-451-5115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OH 18223) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: OH 18519) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2009-06-09 |