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Organization
OHIO NORTH EAST HEALTH SYSTEMS INC
Active
Organization
OHIO NORTH EAST HEALTH SYSTEMS INC
Active
Other names
NORTHSIDE DENTAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD DWINNELLS MD (CEO)
(330) 747-9551
Entity
Organization
Contact information
Practice address
500 GYPSY LANE, MEDICAL OFFICE BLDG A, YOUNGSTOWN, OH 44504-1315
(877) 722-3303
(330) 884-6120
Mailing address
726 WICK AVE, YOUNGSTOWN, OH 44505-2827
(330) 747-9551
(330) 884-6120
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
NULL
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
—
NULL
1223G0001X
General Practice Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
124Q00000X
Dental Hygienist
—
NULL
124Q00000X
Dental Hygienist
—
—
261Q00000X
Clinic/Center
—
NULL
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
03/28/2019
Last updated
03/28/2019
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