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1519 Lyons Rd Centerville OH 45458-1881 | |
(937) 428-2288 | |
(937) 428-4249 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 1519 Lyons Rd, Centerville, Ohio |
Authorized Official Name and Position | Linty John-verghese (OWNER) |
Authorized Official Contact | 9374282288 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1519 Lyons Rd Centerville OH 45458-1881 Ph: (937) 428-2288 | 1519 Lyons Rd Centerville OH 45458-1881 Ph: (937) 428-2288 |
NPI Number | 1164884748 |
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Provider Enumeration Date | 03/23/2016 |
Last Update Date | 11/11/2016 |
Identifier | Type | State | Issuer |
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1164884748 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 30022308 (Ohio) | Primary |
Professional Dental Alliance Of Centerville, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9420 Dayton Lebanon Pike, Centerville, OH 45458 Phone: 937-433-8900 | |