| Utterback Dental Group, Inc | |
|
2414 Whipple Ave Nw Canton OH 44708-1514 | |
| (330) 479-0072 | |
| Not Available |
| Full Name | Utterback Dental Group, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2414 Whipple Ave Nw, Canton, Ohio |
| Authorized Official Name and Position | Benjamin M Utterback (OWNER) |
| Authorized Official Contact | 3305102585 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Utterback Dental Group, Inc 2414 Whipple Ave Nw Canton OH 44708-1514 Ph: (330) 479-0072 | Utterback Dental Group, Inc 2414 Whipple Ave Nw Canton OH 44708-1514 Ph: (330) 479-0072 |
| NPI Number | 1992369896 |
|---|---|
| Provider Enumeration Date | 04/25/2019 |
| Last Update Date | 01/23/2025 |
| Certification Date | 01/23/2025 |
| Medicare PECOS PAC ID | 8325371016 |
|---|---|
| Medicare Enrollment ID | O20190925003937 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992369896 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Secondary |
| 261QD0000X | Clinic/center - Dental | () | Primary |
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