| NPI | 1659716231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY THEIS Owner/Dentist 419-882-1300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30021577) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2013-05-08 |