| NPI | 1891308011 |
|---|---|
| Doing Business As | MAGNOLIA DENTAL CENTERVILLE |
| Entity Type | Organization |
| Authorized Contact | JENNIFER SAMMONS Regional Operations Manager 937-203-1163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-08-27 |
| Last Update Date | 2020-08-27 |