| NPI | 1982650560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON ROBERT EWIG President 937-426-8083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OH 19277) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2020-08-22 |