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General NPI Number Information
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NPI Number | 1770767956
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Entity Type | Organization
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Legal Business Name | DENTAL REFLECTIONS AT NAPOLEON LLC
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Dates
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Enumeration Date | 12/24/2007
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Last Update Date | 12/24/2007
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Provider Practice Location Address
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Address Line | 828 W WASHINGTON ST
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City | NAPOLEON
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State | OH
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Zip | 43545-1306
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Country | US
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Telephone | 419-592-1981
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Fax |
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Provider Business Mailing Address
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Address Line | 828 W WASHINGTON ST
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City | NAPOLEON
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State | OH
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Zip | 43545-1306
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Country | US
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Telephone | 419-592-1981
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. HISHAM KALOTI
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Credential | DDS
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Telephone | 419-893-4060
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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 | 21376
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License Number State | OH
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