| NPI | 1699134015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE BOWMAN Office Manager 419-332-1303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30023596) |
| Enumeration Date | 2016-02-12 |
| Last Update Date | 2018-09-20 |