Healthcare Provider Details

I. General information

NPI: 1417349663
Provider Name (Legal Business Name): COMPLETE DENTAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2015
Last Update Date: 02/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 SUNSET BLVD
STEUBENVILLE OH
43952
US

IV. Provider business mailing address

2700 SUNSET BLVD
STEUBENVILLE OH
43952
US

V. Phone/Fax

Practice location:
  • Phone: 740-264-6811
  • 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 Code122300000X
TaxonomyDentist
License Number023979
License Number StateOH

VIII. Authorized Official

Name: ROBERT ALLEN DOYLE JR.
Title or Position: OWNER
Credential: DMD
Phone: 740-264-6811