| NPI | 1669908224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN M ALBERT Dentist 330-717-4633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 0401414423) |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2017-05-02 |