| Organization Name: | MORROW COUNTY DENTAL, LESLIE MCDOUGALL,DDS,LLC |
| NPI Number: | 1104285329 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LESLIE ANN MCDOUGALL (DENTIST) |
| Mailing Address: | 527 W Marion Rd Ste C Mount Gilead |
| State: | OH US |
| Postal Code: | 433381257 |
| Phone Number: | 4199495007 |
| Fax Number: | 4194649355 |
| NPI Enumeration Date: | 02/16/2016 |
| NPI Last Update Date: | 02/16/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |