| Ellerhorst Dental, Llc | |
|
10730 Main St Apt 2 Mantua OH 44255-8951 | |
| (330) 274-3495 | |
| Not Available |
| Full Name | Ellerhorst Dental, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 10730 Main St Apt 2, Mantua, Ohio |
| Authorized Official Name and Position | Lydia Ellerhorst (DENTIST/OWNER) |
| Authorized Official Contact | 3302214270 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellerhorst Dental, Llc Po Box 350 Mantua OH 44255-0350 Ph: (330) 221-4270 | Ellerhorst Dental, Llc 10730 Main St Apt 2 Mantua OH 44255-8951 Ph: (330) 274-3495 |
| NPI Number | 1740035468 |
|---|---|
| Provider Enumeration Date | 04/17/2024 |
| Last Update Date | 04/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740035468 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |