| NPI | 1881857142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERTA I POWELL Office Manager 330-498-9920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OH 17113) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2008-07-08 |