| NPI | 1952724940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN SHALL President/Oral Surgeon 419-517-4404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: OH 16634) |
| Enumeration Date | 2014-01-27 |
| Last Update Date | 2014-08-12 |