| NPI | 1851409668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANY S ELWORTH COO Rdinator 937-890-4820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 14746) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 14742) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2008-06-24 |