| NPI | 1942587241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY D. SHUE Dentist 740-474-2485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH OH16952) |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2011-11-15 |