| NPI | 1811261712 |
|---|---|
| Other Name | PDA NON-PAR |
| Entity Type | Organization |
| Authorized Contact | ANDREW S MATTA Dentist/Owner 330-533-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2012-02-24 |
| Last Update Date | 2012-02-24 |