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General NPI Number Information
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NPI Number | 1417094475
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Entity Type | Organization
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Legal Business Name | HOSPITAL DENTAL ASSOCIATES INC
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 721 BOARDMAN POLAND RD
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City | BOARDMAN
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State | OH
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Zip | 44512-5107
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Country | US
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Telephone | 330-965-9344
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Fax | 330-965-9347
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Provider Business Mailing Address
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Address Line | 721 BOARDMAN POLAND RD SUITE 203
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City | BOARDMAN
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State | OH
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Zip | 44512-5107
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Country | US
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Telephone | 330-965-9344
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Fax | 330-965-9347
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Authorized Official
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Title or Position | OWNER DOCTOR
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Name | DR. M FRANK BECK
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Credential | DDS MAGD FAAHD
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Telephone | 330-965-9344
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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 | 17005
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License Number State | OH
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