| NPI | 1992110746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN KAY WILSON Owner 614-235-5560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 17498) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2020-01-23 |