| NPI | 1780624635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF THOMAS WARNER President 330-335-1563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30020066) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30016124) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2020-08-22 |