| NPI | 1841479649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD J MCDONNELL President/Owner 330-836-2882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OH 18932) |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2020-10-22 |