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General NPI Number Information
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NPI Number | 1720233000
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Entity Type | Organization
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Legal Business Name | CHOFFIN DENTAL ASSITING SCHOOL
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Dates
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Enumeration Date | 11/30/2008
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Last Update Date | 11/30/2008
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Provider Practice Location Address
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Address Line | 200 E WOOD ST
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City | YOUNGSTOWN
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State | OH
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Zip | 44503-1628
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Country | US
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Telephone | 330-744-8749
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Fax |
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Provider Business Mailing Address
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Address Line | 200 E WOOD ST
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City | YOUNGSTOWN
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State | OH
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Zip | 44503-1628
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Country | US
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Telephone | 330-744-8749
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MRS. PAULA JEAN OLIVER
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Credential | CDA, CDPMA, CODA
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Telephone | 330-744-8749
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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 | 30014994
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License Number State | OH
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