| Immediadent | |
|
4324 Tuscarawas St W Canton OH 44708-5427 | |
| (913) 428-1670 | |
| (913) 800-6967 |
| Full Name | Immediadent |
|---|---|
| Speciality | Dentist |
| Location | 4324 Tuscarawas St W, Canton, Ohio |
| Authorized Official Name and Position | Allee Andrea Mertes (MANAGER OF COMPLIANCE) |
| Authorized Official Contact | 9134281674 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Immediadent Po Box 11568 Overland Park KS 66207-4268 Ph: (913) 428-1670 | Immediadent 4324 Tuscarawas St W Canton OH 44708-5427 Ph: (913) 428-1670 |
| NPI Number | 1245634443 |
|---|---|
| Provider Enumeration Date | 10/17/2014 |
| Last Update Date | 10/17/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245634443 | NPI | - | NPPES |
| 2817349 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (Ohio) | Primary |
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