| NPI | 1679654628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK M LIMA Owner, President 740-852-5771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: OH 17376) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental (Licence: OH 22035) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2020-08-22 |