| NPI | 1699147769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES A SPADAFORE President 740-695-5911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 19529) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WV 3035) |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2015-10-28 |