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General NPI Number Information
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NPI Number | 1003453432
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Entity Type | Organization
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Legal Business Name | LIMAZWICK - BELLEFONTAINE, LLC
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Dates
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Enumeration Date | 12/04/2019
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Last Update Date | 12/16/2019
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Provider Practice Location Address
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Address Line | 1021 N MAIN ST
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City | BELLEFONTAINE
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State | OH
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Zip | 43311-2359
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Country | US
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Telephone | 937-292-7828
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Fax | 937-292-7916
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Provider Business Mailing Address
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Address Line | 1021 N MAIN ST
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City | BELLEFONTAINE
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State | OH
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Zip | 43311-2359
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Country | US
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Telephone | 937-292-7828
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Fax | 937-292-7916
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | STEPHANIE L HUFFMAN
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Credential |
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Telephone | 937-292-7828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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