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General NPI Number Information
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NPI Number | 1255182523
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Entity Type | Organization
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Legal Business Name | WORTHINGTON DENTAL ASSOCIATES LLC
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Dates
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Enumeration Date | 03/27/2024
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Last Update Date | 03/27/2024
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Provider Practice Location Address
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Address Line | 6649 N HIGH ST # B
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City | WORTHINGTON
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State | OH
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Zip | 43085-4070
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Country | US
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Telephone | 614-436-8336
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Fax |
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Provider Business Mailing Address
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Address Line | 95 W ORANGE HILL CIR
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City | CHAGRIN FALLS
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State | OH
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Zip | 44022-2177
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Country | US
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Telephone | 440-263-5490
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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. SHAWN SCHLESSEL
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Credential | DDS
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Telephone | 440-263-5490
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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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