| NPI | 1699073924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ALLEN MOORE CEO Dental Operations 419-874-5324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30023358) |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2011-03-10 |