| NPI | 1780228767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE R KIRBY Office Manager 440-366-3325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2019-11-01 |
| Last Update Date | 2019-12-10 |