| NPI | 1689088056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA LEIGH SULLIVAN Office Manager 614-761-9393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30.016980) |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2014-06-13 |