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General NPI Number Information
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NPI Number | 1982867149
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Entity Type | Organization
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Legal Business Name | MERTES AKRON PEDIATRIC DENTISTRY
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Dates
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Enumeration Date | 07/08/2008
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Last Update Date | 03/24/2016
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Provider Practice Location Address
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Address Line | 5655 HUDSON DR STE 300 STE 300
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City | HUDSON
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State | OH
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Zip | 44236-4454
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Country | US
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Telephone | 330-761-3430
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Fax | 330-655-5435
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Provider Business Mailing Address
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Address Line | 5655 HUDSON DRIVE SUITE 300
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City | HUDSON
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State | OH
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Zip | 44236
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Country | US
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Telephone | 330-655-5437
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Fax | 330-655-5435
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GREGORY C MERTES
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Credential | DMD
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Telephone | 330-655-5437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 3021515
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License Number State | OH
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