| NPI | 1851640445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERENCE ROBERT DENTKOS Sole Member 330-419-0044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: OH 3002020607) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2012-08-29 |