| NPI | 1982970158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA DIANNE MARIANI Co Owner/Dentist 614-336-7643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 20142) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 21803) |
| Enumeration Date | 2012-04-01 |
| Last Update Date | 2012-04-01 |