| NPI | 1962730549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY R MAUERMAN Administrative Director 330-533-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30020654) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30022311) |
| 122300000X Dentist (Licence: OH 30015046) | |
| 122300000X Dentist (Licence: OH 30-012873) | |
| 122300000X Dentist (Licence: OH 30-01955) | |
| 122300000X Dentist (Licence: OH 30-022882) | |
| 122300000X Dentist (Licence: OH 30-023087) | |
| Enumeration Date | 2009-11-19 |
| Last Update Date | 2010-07-20 |