1437521317 NPI number — DENTAL CENTER OF NORTHWEST OHIO

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437521317 NPI number — DENTAL CENTER OF NORTHWEST OHIO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DENTAL CENTER OF NORTHWEST OHIO
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437521317
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/30/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2138 MADISON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOLEDO
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43604-5131
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-241-1644
Provider Business Mailing Address Fax Number:
419-776-1031

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
140 FOX RD
Provider Second Line Business Practice Location Address:
SUITE 207
Provider Business Practice Location Address City Name:
VAN WERT
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45891-2475
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-241-1644
Provider Business Practice Location Address Fax Number:
419-776-1031
Provider Enumeration Date:
10/30/2015

Additional Information

Authorized Official

Authorized Official Last Name:
CREE
Authorized Official First Name:
MELINDA S. CREE
Authorized Official Middle Name:
S
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
419-261-1644

Provider Taxonomy Codes

  • Taxonomy code: 261QD0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com