| NPI | 1760777247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL D ROSVALL President 614-404-9429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: UT 6834576-9921) |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2011-06-13 |