| NPI | 1689070062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY M THOMPSON President 614-893-0256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 29857) |
| Enumeration Date | 2014-11-12 |
| Last Update Date | 2018-08-09 |