| NPI | 1992716385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK ALLAN CHANEY Owner 419-227-5155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OH 30017635) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2020-08-22 |