| Lawrence County Dental Sealant Program | |
|
111 S 4th St Third Floor Courthouse Ironton OH 45638-1522 | |
| (740) 532-4223 | |
| Not Available |
| Full Name | Lawrence County Dental Sealant Program |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 111 S 4th St, Ironton, Ohio |
| Authorized Official Name and Position | Harold Shafer (SUPERINTENDENT) |
| Authorized Official Contact | 7405324223 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lawrence County Dental Sealant Program 111 S 4th St Third Floor Courthouse Ironton OH 45638-1522 Ph: (740) 532-4223 | Lawrence County Dental Sealant Program 111 S 4th St Third Floor Courthouse Ironton OH 45638-1522 Ph: (740) 532-4223 |
| NPI Number | 1598802571 |
|---|---|
| Provider Enumeration Date | 01/31/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598802571 | NPI | - | NPPES |
| 2461545 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 17404 (Ohio) | Primary |
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