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Organization
TM WYLAND DENTAL LAB II
Active
Organization
TM WYLAND DENTAL LAB II
Active
Other names
Lordstown Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW ALAN BIDDLE (PRESIDENT)
(330) 824-2515
Entity
Organization
Contact information
Practice address
947 HALLOCK YOUNG RD SW, WARREN, OH 44481-9636
(330) 824-2515
(330) 824-2333
Mailing address
947 HALLOCK YOUNG RD SW, WARREN, OH 44481-9636
(330) 824-2515
(330) 824-2333
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0541677
—
OH
05
—
2037076
—
OH
Enumeration date
11/19/2014
Last updated
11/19/2014
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