Healthcare Provider Details
I. General information
NPI: 1932594827
Provider Name (Legal Business Name): M PINTER DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/30/2015
Last Update Date: 03/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
555 PARKVIEW ST
WAUSEON OH
43567-1239
US
IV. Provider business mailing address
555 PARKVIEW ST
WAUSEON OH
43567-1239
US
V. Phone/Fax
- Phone: 419-335-3018
- Fax: 419-335-4977
- Phone: 419-335-3018
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | 30-023198 |
| License Number State | OH |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: DR.
MICHAEL
PINTER
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 419-335-3018