| NPI | 1801893888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY R ERENA President 859-268-4423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2009-03-20 |