| NPI | 1912250135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY A PURCELL Owner/Dentist 614-885-4249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: MI 15174) |
| Additional Taxonomies | 1223P0700X Dentist Prosthodontics (Licence: IL 22655) |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2020-11-05 |