| Champaign Dental Group, Inc. | |
|
139 Patrick Ave Urbana OH 43078-2123 | |
| (937) 653-8650 | |
| (937) 653-8606 |
| Full Name | Champaign Dental Group, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 139 Patrick Ave, Urbana, Ohio |
| Authorized Official Name and Position | Amanda Michelle Mayse (OFFICE MANAGER) |
| Authorized Official Contact | 9376538650 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Champaign Dental Group, Inc. 139 Patrick Ave Urbana OH 43078-2123 Ph: (937) 653-8650 | Champaign Dental Group, Inc. 139 Patrick Ave Urbana OH 43078-2123 Ph: (937) 653-8650 |
| NPI Number | 1598771321 |
|---|---|
| Provider Enumeration Date | 08/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598771321 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 15524 (Ohio) | Primary |
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