Individual
DR. JON BRUCE DOVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
601 W BOUNDARY ST, PERRYSBURG, OH 43551-1201
(419) 872-9191
Mailing address
601 W BOUNDARY ST, PERRYSBURG, OH 43551-1201
(419) 872-9191
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19539
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
803897
UNITED CONCORDIA PROVIDER
OH
Enumeration date
09/27/2007
Last updated
12/01/2016
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