| NPI | 1760687206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARION L. OSTER Owner 440-461-1157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: OH 16807) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2020-08-22 |