Healthcare Provider Details

I. General information

NPI: 1154841609
Provider Name (Legal Business Name): COMPLETE DENTAL CARE OF NEWCMERSTOWN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2017
Last Update Date: 06/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 S RIVER ST
NEWCOMERSTOWN OH
43832-1118
US

IV. Provider business mailing address

2700 SUNSET BLVD
STEUBENVILLE OH
43952-1158
US

V. Phone/Fax

Practice location:
  • Phone: 740-498-5155
  • Fax: 740-264-6812
Mailing address:
  • Phone: 740-264-6811
  • Fax: 740-264-6812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: ARMANDA LESTER
Title or Position: OFFICE MANAGER
Credential:
Phone: 740-485-0309