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General NPI Number Information
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NPI Number | 1134641897
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Entity Type | Organization
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Legal Business Name | AFFORDABLE DENTURES-MANSFIELD, SUSAN CAMPBELL, DDS, INC
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Dates
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Enumeration Date | 07/13/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2010 AUGUST DR STE 106
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City | ONTARIO
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State | OH
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Zip | 44906-3350
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Country | US
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Telephone | 419-529-0142
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Fax |
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Provider Business Mailing Address
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Address Line | 2010 AUGUST DR STE 106
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City | ONTARIO
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State | OH
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Zip | 44906-3350
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Country | US
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Telephone | 419-529-0142
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Fax |
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | SUSAN CAMPBELL
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Credential | DDS
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Telephone | 419-529-0142
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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