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2500 W. Strub Rd. Noms Professional Bldg. #1 Sandusky OH 44870 | |
| (419) 627-8131 | |
| (419) 621-1773 |
| Full Name | |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 2500 W. Strub Rd., Sandusky, Ohio |
| Authorized Official Name and Position | Terence Patrick Kelly (PRESIDENT) |
| Authorized Official Contact | 4196278131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2500 W. Strub Rd. Noms Professional Bldg. #1 Sandusky OH 44870 Ph: (419) 627-8131 | 2500 W. Strub Rd. Noms Professional Bldg. #1 Sandusky OH 44870 Ph: (419) 627-8131 |
| NPI Number | 1609916667 |
|---|---|
| Provider Enumeration Date | 02/07/2007 |
| Last Update Date | 02/02/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609916667 | NPI | - | NPPES |
| 2089789 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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