| NPI | 1982879649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENT N NICKLAS Owner/Dentist 440-234-4646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 18994) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2008-04-24 |