| Corcoran Privitera Family Dental Llc | |
|
15 Shaker Run Rd Peebles OH 45660-9401 | |
| (937) 587-3903 | |
| Not Available |
| Full Name | Corcoran Privitera Family Dental Llc |
|---|---|
| Speciality | Dentist |
| Location | 15 Shaker Run Rd, Peebles, Ohio |
| Authorized Official Name and Position | Brandon M Privitera (OWNER) |
| Authorized Official Contact | 4404152334 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Corcoran Privitera Family Dental Llc 415 Market St Piketon OH 45661-9111 Ph: (440) 415-2334 | Corcoran Privitera Family Dental Llc 15 Shaker Run Rd Peebles OH 45660-9401 Ph: (937) 587-3903 |
| NPI Number | 1952035859 |
|---|---|
| Provider Enumeration Date | 07/15/2022 |
| Last Update Date | 07/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952035859 | NPI | - | NPPES |
| 1376586669 | Other | NPI | |
| 1669037529 | Other | NPI | |
| 0349182 | Medicaid | OH | |
| 0521224 | Medicaid | OH | |
| 0349186 | Medicaid | OH | |
| 1326603283 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
Franklin Dental And Health Care, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 15 Shaker Run Rd, Peebles, OH 45660 Phone: 937-587-3903 Fax: 937-587-3302 |