| NPI | 1770825572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY LOWELL Administrative Assistant 937-938-5529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 23113) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2013-03-20 |