MEDICARE: POINT PLACE DENTAL CARE

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
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1871224956
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POINT PLACE DENTAL CARE

Provider Business Mailing Address
First Line	:	4611 N SUMMIT ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43611-2812
Country	:	US
Telephone Number	:	419-729-3972
Fax Number	:

Provider Business Practice Location Address
First Line	:	4611 N SUMMIT ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43611-2812
Country	:	US
Telephone Number	:	419-729-3972
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. NADEEM KHAN
Credential	:	DDS
Telephone Number	:	419-473-8885

Provider Enumeration Date	:	06/21/2022
Last Update Date	:	06/21/2022

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Directions to “POINT PLACE DENTAL CARE ” Practice Location

Language	Start Address	Practice Location

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