Healthcare Provider Details

I. General information

NPI: 1811146939
Provider Name (Legal Business Name): NORTHERN OHIO FOOT AND ANKLE SPECIALISTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2008
Last Update Date: 04/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 E WILLARD AVE
NORWALK OH
44857-1155
US

IV. Provider business mailing address

1 E WILLARD AVE
NORWALK OH
44857-1155
US

V. Phone/Fax

Practice location:
  • Phone: 419-660-0099
  • Fax:
Mailing address:
  • Phone: 419-660-0099
  • Fax: 419-660-0098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number36-3148
License Number StateOH

VIII. Authorized Official

Name: DR. MARC DOMINICK DOLCE
Title or Position: PRESIDENT
Credential: D.P.M.
Phone: 419-660-0099