NPI | 1801067665 |
---|---|
Entity Type | Organization |
Authorized Contact | DONALD RAY LEE Owner 614-547-0001 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30014112) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30021473) |
Enumeration Date | 2008-03-19 |
Last Update Date | 2011-06-13 |