| NPI | 1881191419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEYMAN FATTAHI Dentist 937-474-2972 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OH 30-024177) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2018-04-10 |