| NPI | 1770860728 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY JOSE Owner 614-428-7320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: 30019954) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: OH 30020138) |
| Enumeration Date | 2011-11-04 |
| Last Update Date | 2011-11-04 |