| NPI | 1679181390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCAS MCGUIRE Owner 440-349-1129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2020-07-20 |