| NPI | 1881754026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLLIE MAE ANTHONY Office Manager 937-492-1790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 014420) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2020-08-22 |