| City Wide Dental Services | |
|
725 Miami St Toledo OH 43605-2278 | |
| (419) 693-4712 | |
| (419) 693-4495 |
| Full Name | City Wide Dental Services |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 725 Miami St, Toledo, Ohio |
| Authorized Official Name and Position | Mark Joseph Heenan (PRESIDENT) |
| Authorized Official Contact | 4196934712 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| City Wide Dental Services 725 Miami St Toledo OH 43605-2278 Ph: (419) 693-4712 | City Wide Dental Services 725 Miami St Toledo OH 43605-2278 Ph: (419) 693-4712 |
| NPI Number | 1164530259 |
|---|---|
| Provider Enumeration Date | 08/28/2006 |
| Last Update Date | 10/02/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164530259 | NPI | - | NPPES |
| 04944 | Other | OH | PARAMOUNT |
| 2618984 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 17029 (Ohio) | Primary |
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