| Tm Wyland Dental Lab Ii | |
|
947 Hallock Young Rd Sw Warren OH 44481-9636 | |
| (330) 824-2515 | |
| (330) 824-2333 |
| Full Name | Tm Wyland Dental Lab Ii |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 947 Hallock Young Rd Sw, Warren, Ohio |
| Authorized Official Name and Position | Andrew Alan Biddle (PRESIDENT) |
| Authorized Official Contact | 3308242515 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tm Wyland Dental Lab Ii 947 Hallock Young Rd Sw Warren OH 44481-9636 Ph: (330) 824-2515 | Tm Wyland Dental Lab Ii 947 Hallock Young Rd Sw Warren OH 44481-9636 Ph: (330) 824-2515 |
| NPI Number | 1205233277 |
|---|---|
| Provider Enumeration Date | 11/19/2014 |
| Last Update Date | 11/19/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205233277 | NPI | - | NPPES |
| 2037076 | Medicaid | OH | |
| 0541677 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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