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General NPI Number Information
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NPI Number | 1770795205
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Entity Type | Organization
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Legal Business Name | DUCHON ORTHODONTICS
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 04/21/2009
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Provider Practice Location Address
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Address Line | 3536 GLENDALE
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City | TOLEDO
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State | OH
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Zip | 43614
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Country | US
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Telephone | 419-385-7777
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Fax | 419-385-6446
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Provider Business Mailing Address
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Address Line | 3536 GLENDALE
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City | TOLEDO
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State | OH
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Zip | 43614
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Country | US
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Telephone | 419-385-7777
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Fax | 419-385-6446
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Authorized Official
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Title or Position | DOCTOR
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Name | STUART LEE DUCHON
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Credential | DDS, MS
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Telephone | 419-385-7777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 30014597
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License Number State | OH
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