Meckler Dental Providers (oregon), INC

NPI #1114017639 in Oregon, Ohio

Provider Information

NPI Number: 1114017639
Entity Type: Organization
Organization Name: Meckler Dental Providers (oregon), INC
Subpart: Yes (part of a larger organization)
Parent Organization: DENTALONE PARTNERS, INC
Primary Specialty: Dentist
Enumeration Date: Oct 13, 2006
Last Updated: Feb 6, 2018

Practice Location

Address: 3555 NAVARRE AVE STE 12
City: Oregon
State: Ohio
ZIP Code: 43616-3459
Phone: (419) 690-0320

Authorized Official

Name: RACHEL NITTINGER
Title: MANAGER, CREDENTIALING
Phone: (972) 755-0816

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Endodontics — Endodontics	1223E0200X
Dentist - General Practice — General Practice	1223G0001X
Dentist - Periodontics — Periodontics	1223P0300X
Dentist - Prosthodontics — Prosthodontics	1223P0700X
Dentist - Pediatric Dentistry — Pediatric Dentistry	1223P0221X
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X
Dentist	122300000X	Primary

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