Lorain County Health & Dentistry

NPI #1598930877 in Lorain, Ohio

Provider Information

NPI Number: 1598930877
Entity Type: Organization
Organization Name: Lorain County Health & Dentistry
Primary Specialty: Clinic/Center - Federally Qualified Health Center (FQHC)
Enumeration Date: Apr 28, 2008
Last Updated: Sep 30, 2013

Practice Location

Address: 3745 GROVE AVE
City: Lorain
State: Ohio
ZIP Code: 44055
Phone: (440) 240-1655

Authorized Official

Name: STEPHANIE WIERSMA
Title: PRESIDENT & CEO
Phone: (440) 233-1059

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X
Oral & Maxillofacial Surgery	204E00000X
Family Medicine	207Q00000X
Internal Medicine	207R00000X
Obstetrics & Gynecology	207V00000X
Pediatrics	208000000X
Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC)	261QF0400X	Primary

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