| NPI | 1891813887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN CHARLES GOODRICH President Owner 440-248-2825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |