| Portage Dental Group, Jeffrey S. Rosenthal D.d.s., Inc. | |
|
644 S Chestnut St Ravenna OH 44266-3035 | |
| (330) 297-7009 | |
| Not Available |
| Full Name | Portage Dental Group, Jeffrey S. Rosenthal D.d.s., Inc. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 644 S Chestnut St, Ravenna, Ohio |
| Authorized Official Name and Position | Jeffrey S. Rosenthal (OWNER) |
| Authorized Official Contact | 2169058454 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Portage Dental Group, Jeffrey S. Rosenthal D.d.s., Inc. 644 S Chestnut St Ravenna OH 44266-3035 Ph: (330) 297-7009 | Portage Dental Group, Jeffrey S. Rosenthal D.d.s., Inc. 644 S Chestnut St Ravenna OH 44266-3035 Ph: (330) 297-7009 |
| NPI Number | 1518583608 |
|---|---|
| Provider Enumeration Date | 06/24/2020 |
| Last Update Date | 11/22/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518583608 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Portage Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 250 S Chestnut St Ste 30, Ravenna, OH 44266 Phone: 330-297-7009 Fax: 330-297-0901 |