NPI | 1760661789 |
---|---|
Entity Type | Organization |
Authorized Contact | JEFFREY RICHARD MCCLAIN President 330-856-7950 |
Organization Subpart ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: OH 35075926) |
Enumeration Date | 2007-10-25 |
Last Update Date | 2007-10-25 |