| Ohio Street Family Dental Group, Llc | |
|
406 Ohio St Elyria OH 44035-3925 | |
| (440) 937-8878 | |
| Not Available |
| Full Name | Ohio Street Family Dental Group, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 406 Ohio St, Elyria, Ohio |
| Authorized Official Name and Position | Sheona Kimmel (OFFICE MANAGER) |
| Authorized Official Contact | 4409378878 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ohio Street Family Dental Group, Llc 5201 N Abbe Rd Sheffield Village OH 44035-1451 Ph: (440) 937-8878 | Ohio Street Family Dental Group, Llc 406 Ohio St Elyria OH 44035-3925 Ph: (440) 937-8878 |
| NPI Number | 1083108435 |
|---|---|
| Provider Enumeration Date | 06/19/2018 |
| Last Update Date | 06/19/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083108435 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 30.020075 (Ohio) | Primary |
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