Grand Lake Family Dentistry, Ltd. | |
800 E Wayne St Celina OH 45822-1359 | |
(419) 586-1615 | |
(419) 586-1616 |
Full Name | Grand Lake Family Dentistry, Ltd. |
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Speciality | Dentist |
Location | 800 E Wayne St, Celina, Ohio |
Authorized Official Name and Position | Travis Duane Lutz (PRESIDENT) |
Authorized Official Contact | 4195861615 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Grand Lake Family Dentistry, Ltd. 800 E Wayne St Po Box 316 Celina OH 45822-1359 Ph: (419) 586-1615 | Grand Lake Family Dentistry, Ltd. 800 E Wayne St Celina OH 45822-1359 Ph: (419) 586-1615 |
NPI Number | 1952428310 |
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Provider Enumeration Date | 03/23/2007 |
Last Update Date | 12/20/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952428310 | NPI | - | NPPES |
9182631 | Other | DENTAQUEST | |
2057965 | Medicaid | OH | |
06131 | Other | PARAMOUNT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 30.020826 (Ohio) | Primary |
Dentistry For You, Forsthoefel And Schleucher, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 136 N. Enterprise St., Celina, OH 45822 Phone: 419-586-1661 Fax: 419-584-0424 | |
Willmann Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1304 Meadowview Dr, Celina, OH 45822 Phone: 419-586-4738 Fax: 419-586-5222 | |
William H Wiley Dds Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 405 Myers Rd, Celina, OH 45822 Phone: 419-586-4738 Fax: 419-586-5222 |