Northwest Ohio Dental Specility Center,llc

NPI #1144757469 in Napoleon, Ohio

Provider Information

NPI Number: 1144757469
Entity Type: Organization
Organization Name: Northwest Ohio Dental Specility Center,llc
Primary Specialty: Dentist - Periodontics
Enumeration Date: May 17, 2017
Last Updated: Jun 12, 2017

Practice Location

Address: 610 BROADMOOR AVE
City: Napoleon
State: Ohio
ZIP Code: 43545-1288
Phone: (419) 592-5854

Authorized Official

Name: MRS. STACY LYNN FRESHOUR
Title: PRACTICE ADMINISTRATOR
Phone: (419) 592-9956

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Periodontics — Periodontics	1223P0300X	Primary

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