| NPI | 1962707133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW S MATTA Member 330-533-3400 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30022469) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30022469) |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2011-01-20 |