NPI | 1770142564 |
---|---|
Doing Business As | SPRING VALLEY DENTAL |
Entity Type | Organization |
Authorized Contact | JASON DERRICK DITERLIZZI Dentist 419-340-2054 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2019-06-06 |
Last Update Date | 2019-06-06 |