|
| |
|
709 S. Market Street Danville OH 43014 | |
| (740) 599-6882 | |
| (740) 599-7479 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 709 S. Market Street, Danville, Ohio |
| Authorized Official Name and Position | Aaron F Lerg (PRESIDENT) |
| Authorized Official Contact | 7405996882 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
P.o. Box 3 709 S. Market St Danville OH 43014 Ph: (740) 599-6882 | 709 S. Market Street Danville OH 43014 Ph: (740) 599-6882 |
| NPI Number | 1295912186 |
|---|---|
| Provider Enumeration Date | 01/23/2008 |
| Last Update Date | 05/08/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295912186 | NPI | - | NPPES |
| 2231534 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 18224 (Ohio) | Primary |
| 122300000X | Dentist | 21328 (Ohio) | Secondary |