| NPI | 1992097257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PENNY A ROGERS Office Manager 937-433-8303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 16938) |
| Enumeration Date | 2011-05-05 |
| Last Update Date | 2011-05-05 |