| NPI | 1992811921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH A. KOBERLEIN President 330-688-9922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: OH 18241) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2020-08-22 |