| Womack Dayton Pediatric Dentistry Inc | |
|
1 Childrens Plz Suite 2070 Dayton OH 45404-1898 | |
| (937) 641-5098 | |
| (937) 641-5448 |
| Full Name | Womack Dayton Pediatric Dentistry Inc |
|---|---|
| Speciality | Dentist |
| Location | 1 Childrens Plz, Dayton, Ohio |
| Authorized Official Name and Position | Gordon W Womack (OWNER) |
| Authorized Official Contact | 9376415098 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Womack Dayton Pediatric Dentistry Inc 1 Childrens Plaza Suite 2070 Dayton OH 45404 Ph: (937) 641-3455 | Womack Dayton Pediatric Dentistry Inc 1 Childrens Plz Suite 2070 Dayton OH 45404-1898 Ph: (937) 641-5098 |
| NPI Number | 1710032305 |
|---|---|
| Provider Enumeration Date | 01/24/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710032305 | NPI | - | NPPES |
| 0617587 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 17287 (Ohio) | Primary |
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