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Contact Information

555 W ELM ST DENTISTRY LLC
555 W ELM ST
LIMA, OH45801-4757
 Phone: 419-229-0776
 Fax: 419-229-3828
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for 555 W ELM ST DENTISTRY LLC · (Female)

NPI # 1043351034
Status Active
Credentials
Entity Individual
Enumeration date 02/10/2007
Last updated 03/19/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • OH License # 30 . 20842
  • OH Medicaid 2081376
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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