| Berea Family Dental | |
|
20 S Limestone St Suite110 Springfield OH 45502-2219 | |
| (937) 322-7832 | |
| Not Available |
| Full Name | Berea Family Dental |
|---|---|
| Speciality | Dentist |
| Location | 20 S Limestone St, Springfield, Ohio |
| Authorized Official Name and Position | Kathy Nelson (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 9372064080 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Berea Family Dental 359 Front St Berea OH 44017-1760 Ph: (440) 234-2813 | Berea Family Dental 20 S Limestone St Suite110 Springfield OH 45502-2219 Ph: (937) 322-7832 |
| NPI Number | 1780079038 |
|---|---|
| Provider Enumeration Date | 04/03/2015 |
| Last Update Date | 04/03/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780079038 | NPI | - | NPPES |
| 2809232 | Medicaid | OH | |
| 0431321 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 15902 (Ohio) | Primary |
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