| Northwest Ohio Dental Specility Center,llc | |
|
610 Broadmoor Ave Napoleon OH 43545-1288 | |
| (419) 592-5854 | |
| (419) 930-6500 |
| Full Name | Northwest Ohio Dental Specility Center,llc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 610 Broadmoor Ave, Napoleon, Ohio |
| Authorized Official Name and Position | Stacy Lynn Freshour (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 4195929956 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Ohio Dental Specility Center,llc 610 Broadmoor Ave Napoleon OH 43545-1288 Ph: (419) 592-9956 | Northwest Ohio Dental Specility Center,llc 610 Broadmoor Ave Napoleon OH 43545-1288 Ph: (419) 592-5854 |
| NPI Number | 1144757469 |
|---|---|
| Provider Enumeration Date | 05/17/2017 |
| Last Update Date | 06/12/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144757469 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 30022360 (Ohio) | Primary |
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