| NPI | 1669855144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID STANCZYK Authorized Official 937-262-2102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH RES.3597) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2015-07-02 |