| Tlc Dental Center Llc | |
|
1127 W 5th St Marysville OH 43040-9282 | |
| (937) 642-2400 | |
| (937) 642-2490 |
| Full Name | Tlc Dental Center Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1127 W 5th St, Marysville, Ohio |
| Authorized Official Name and Position | Hae Su Yim (OWNER, DENTIST) |
| Authorized Official Contact | 9376422400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tlc Dental Center Llc 1127 W 5th St Marysville OH 43040-9282 Ph: (937) 642-2400 | Tlc Dental Center Llc 1127 W 5th St Marysville OH 43040-9282 Ph: (937) 642-2400 |
| NPI Number | 1942467808 |
|---|---|
| Provider Enumeration Date | 05/19/2008 |
| Last Update Date | 05/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942467808 | NPI | - | NPPES |
| 179363 - LOCATION # | Other | OH | MOLINA HEALTHCARE OF OHIO |
| 2572470 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 30-022153 (Ohio) | Primary |
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