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 |