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39037 Center Ridge Rd North Ridgeville OH 44039-2741 | |
| (440) 327-1021 | |
| (440) 327-1171 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 39037 Center Ridge Rd, North Ridgeville, Ohio |
| Authorized Official Name and Position | Stephen D. Jordan (PRESIDENT) |
| Authorized Official Contact | 3303362542 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
176 Akron Rd Wadsworth OH 44281-1918 Ph: (330) 336-2542 | 39037 Center Ridge Rd North Ridgeville OH 44039-2741 Ph: (440) 327-1021 |
| NPI Number | 1104020171 |
|---|---|
| Provider Enumeration Date | 06/13/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104020171 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 30-7 (Ohio) | Primary |
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