Portage Dental Center

NPI #1316093024 in Ravenna, Ohio

Provider Information

NPI Number: 1316093024
Entity Type: Organization
Organization Name: Portage Dental Center
Primary Specialty: Dentist - General Practice
Enumeration Date: Jan 26, 2007
Last Updated: Feb 19, 2014

Practice Location

Address: 250 S CHESTNUT ST STE 30
City: Ravenna
State: Ohio
ZIP Code: 44266-3031
Phone: (330) 297-7009

Authorized Official

Name: MS. ANN HARRY
Title: OFFICE ADMINISTRATOR MGR
Phone: (330) 297-7009

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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