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NPI Code Detail

MEDICARE: DR. ERIN NICOLE-DEAL VIEIRA D.D.S.

MEDICARE:  DR. ERIN NICOLE-DEAL VIEIRA  D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist30.023644OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
130.023644OTHEROHDENTAL BOARD

General Provider Information

NPI Number : 1710267398
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERIN NICOLE-DEAL VIEIRA D.D.S.
Provider Business Mailing Address
First Line : 347 WOODSIDE DR
Second Line :
City : JOHNSTOWN
State : OH
Zip : 43031-1385
Country : US
Telephone Number : 419-345-3253
Fax Number :
Provider Business Practice Location Address
First Line : 3927 COLUMBUS RD
Second Line :
City : CENTERBURG
State : OH
Zip : 43011
Country : US
Telephone Number : 419-345-3253
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2011
Last Update Date : 06/14/2018

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Directions to “ DR. ERIN NICOLE-DEAL VIEIRA D.D.S.” Practice Location

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