| NPI | 1770119539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENEDICT KIM Owner 440-552-5627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2020-03-12 |
| Last Update Date | 2020-03-12 |