| NPI | 1700927498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM DECKER SQUIRES President 440-331-0055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: OH 12981) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2016-07-14 |