| NPI | 1962438226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD GLENN KINKELAAR President Owner 216-671-0474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30011416) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2020-08-22 |