# OLLOM COMMUNITY DENTAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871067504
- **Authorized official:** JANE ANN CAMPBELL (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (419) 228-4036

## Contact information

- **Practice address:** 1702 ALLENTOWN RD, LIMA, OH 45805-1845
- **Practice address phone:** (419) 222-0693
- **Mailing address:** 1702 ALLENTOWN RD, LIMA, OH 45805-1845
- **Mailing address phone:** (419) 222-0693
- **Mailing address fax:** (419) 879-6478

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/16/2019
- **Last updated:** 11/30/2020