| NPI | 1902341233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNA BRANDENSTEIN Office Manager 330-372-6888 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 018833) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 023891) |
| Enumeration Date | 2016-12-22 |
| Last Update Date | 2016-12-22 |