| NPI | 1972913200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY JAMES BACKIEWICZ President 614-855-0202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30-019554) |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2014-05-08 |