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General NPI Number Information
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NPI Number | 1093306565
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Entity Type | Organization
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Legal Business Name | SMILES OHIO STUART L DUCHON DMD MS LLC
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Dates
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Enumeration Date | 01/28/2021
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Last Update Date | 02/01/2021
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Provider Practice Location Address
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Address Line | 8 COLUMBUS ST
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City | BEDFORD
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State | OH
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Zip | 44146-2819
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Country | US
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Telephone | 440-799-0030
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Fax |
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Provider Business Mailing Address
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Address Line | 8 COLUMBUS ST
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City | BEDFORD
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State | OH
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Zip | 44146-2819
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Country | US
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Telephone | 440-799-0030
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. STUART DUCHON
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Credential | DMD.,MS
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Telephone | 440-799-0030
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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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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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