| NPI | 1760745756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW JUSTEN DEAK President 440-667-2224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 022513) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 022343) |
| Enumeration Date | 2012-06-24 |
| Last Update Date | 2012-06-24 |