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General NPI Number Information
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NPI Number | 1487877874
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Entity Type | Organization
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Legal Business Name | T M WYLAND DENTAL LAB II INC
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 947 HALLOCK YOUNG RD SW
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City | WARREN
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State | OH
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Zip | 44481-9636
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Country | US
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Telephone | 330-824-2515
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Fax | 330-824-2333
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Provider Business Mailing Address
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Address Line | 947 HALLOCK YOUNG RD SW
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City | WARREN
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State | OH
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Zip | 44481-9636
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Country | US
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Telephone | 330-824-2515
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Fax | 330-824-2333
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Authorized Official
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Title or Position | TREASURER
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Name | MYRON KENNETH BIDDLE III
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Credential |
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Telephone | 814-946-8189
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 292200000X
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Taxonomy Name | Dental Laboratory
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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 | 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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