| NPI | 1770633075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIYE DUNLAP Billing Specialist 216-382-1102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 020238) |
| Additional Taxonomies | 124Q00000X Dental Hygienist |
| 126800000X Dental Assistant | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2020-08-22 |