| Family Dental Team, Inc. | |
|
620 Ridgewood Xing Suite K Fairlawn OH 44333-3531 | |
| (330) 376-9424 | |
| (330) 376-2298 |
| Full Name | Family Dental Team, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 620 Ridgewood Xing, Fairlawn, Ohio |
| Authorized Official Name and Position | James D George (PRESIDENT/OWNER) |
| Authorized Official Contact | 3303769424 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Dental Team, Inc. 620 Ridgewood Xing Suite K Fairlawn OH 44333-3531 Ph: (330) 376-9424 | Family Dental Team, Inc. 620 Ridgewood Xing Suite K Fairlawn OH 44333-3531 Ph: (330) 376-9424 |
| NPI Number | 1205008828 |
|---|---|
| Provider Enumeration Date | 03/25/2008 |
| Last Update Date | 08/13/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205008828 | NPI | - | NPPES |
| 2531148 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 30-012228 (Ohio) | Primary |
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