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345 E Main St Suite E Jackson OH 45640 | |
| (740) 288-0208 | |
| (740) 288-9878 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 345 E Main St, Jackson, Ohio |
| Authorized Official Name and Position | Jan Green (BUSINESS MANAGER) |
| Authorized Official Contact | 7407734066 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
345 E Main St Suite E Jackson OH 45640 Ph: (740) 288-0208 | 345 E Main St Suite E Jackson OH 45640 Ph: (740) 288-0208 |
| NPI Number | 1316024557 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316024557 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Southern Ohio Mini Dental Implant Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 41 E South St, Jackson, OH 45640 Phone: 740-577-3230 |