| NPI | 1770898074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY R MAUERMAN Executive Admin 330-533-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30-019480) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30-023197) |
| 122300000X Dentist (Licence: OH 30-023233) | |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2010-08-11 |