| NPI | 1801915004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES CONROY Orthodontist 614-775-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 13859) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 21227) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2008-09-23 |