| NPI | 1912283367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANELLE REES Administrator 614-222-4262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30012752) |
| Enumeration Date | 2011-10-31 |
| Last Update Date | 2011-10-31 |