# HOLMES CO. BOARD OF MRDD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** HCTC Dental Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417018003
- **Authorized official:** MR. F. SCOTT BRACE (SUPERINTENDENT)
- **Authorized official phone:** (330) 674-8045

## Contact information

- **Practice address:** 8001 TOWNSHIP ROAD 574, HOLMESVILLE, OH 44633-9751
- **Practice address phone:** (330) 674-8045
- **Practice address fax:** (330) 674-5182
- **Mailing address:** 8001 TOWNSHIP ROAD 574, HOLMESVILLE, OH 44633-9751
- **Mailing address phone:** (330) 674-8045
- **Mailing address fax:** (330) 674-5182

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223D0001X | Public Health Dentistry | — | NULL | Yes |
| 1223D0001X | Public Health Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 12/13/2006
- **Last updated:** 08/22/2020