| NPI | 1730862202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN LOWERY Practice Manager 614-396-8286 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2023-08-10 |
| Last Update Date | 2023-08-10 |