| NPI | 1932117553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNARD JOSEPH JOHNSON President 330-493-4242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: OH 13689) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2020-08-22 |