NPI | 1720712938 |
---|---|
Entity Type | Organization |
Authorized Contact | CHARLES W VITTITOW Owner 502-523-3514 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
Enumeration Date | 2022-07-13 |
Last Update Date | 2022-08-12 |