| Woodlawn Dental Center, Inc. | |
|
1109 Woodlawn Ave Cambridge OH 43725-3025 | |
| (740) 439-4799 | |
| (740) 439-1716 |
| Full Name | Woodlawn Dental Center, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 1109 Woodlawn Ave, Cambridge, Ohio |
| Authorized Official Name and Position | Franklin Maximo (PRESIDENT) |
| Authorized Official Contact | 7404394799 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Woodlawn Dental Center, Inc. 1109 Woodlawn Ave Cambridge OH 43725-3025 Ph: (740) 439-4799 | Woodlawn Dental Center, Inc. 1109 Woodlawn Ave Cambridge OH 43725-3025 Ph: (740) 439-4799 |
| NPI Number | 1740321777 |
|---|---|
| Provider Enumeration Date | 02/11/2007 |
| Last Update Date | 04/23/2021 |
| Medicare PECOS PAC ID | 0345656583 |
|---|---|
| Medicare Enrollment ID | O20210312000358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740321777 | NPI | - | NPPES |
| 2445563 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 30-019330 (Ohio) | Primary |
| Provider Name | Franklin Maximo |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1164553046 PECOS PAC ID: 1052727294 Enrollment ID: I20210426000515 |
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