| NPI | 1881605772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY JAMES BRANDAU Owner 330-497-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 16040) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2020-08-22 |