Organization Name: | DENTAL CENTER OF NORTHWEST OHIO |
NPI Number: | 1437521317 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MELINDA S. CREE S CREE (EXECUTIVE DIRECTOR) |
Mailing Address: | 140 Fox Rd Suite 207 Van Wert |
State: | OH US |
Postal Code: | 458912475 |
Phone Number: | 4192411644 |
Fax Number: | 4197761031 |
NPI Enumeration Date: | 10/30/2015 |
NPI Last Update Date: | 10/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |