Family Dentistry On The Square, Inc | |
111 Main St Wadsworth OH 44281-1433 | |
(330) 336-5788 | |
(330) 334-1425 |
Full Name | Family Dentistry On The Square, Inc |
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Speciality | Dentist |
Location | 111 Main St, Wadsworth, Ohio |
Authorized Official Name and Position | Robert R Guthrie (OWNER/DENTIST) |
Authorized Official Contact | 3303365788 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Family Dentistry On The Square, Inc 111 Main St Wadsworth OH 44281-1433 Ph: (330) 336-5788 | Family Dentistry On The Square, Inc 111 Main St Wadsworth OH 44281-1433 Ph: (330) 336-5788 |
NPI Number | 1790233971 |
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Provider Enumeration Date | 09/15/2016 |
Last Update Date | 09/15/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790233971 | NPI | - | NPPES |
0407018 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 30-16242 (Ohio) | Primary |
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