| NPI | 1750782298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSTANTIN FARAH CEO 330-494-7004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2014-09-15 |