Organization
JEFFERY B. STOLLER D.D.S I.N.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFERY STOLLER (DENTIST)
(419) 687-4345
Entity
Organization
Contact information
Practice address
4 E MAIN ST, PLYMOUTH, OH 44865-1081
(419) 687-4345
Mailing address
4 E MAIN ST, P.O. BOX 46, PLYMOUTH, OH 44865-1081
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
17426
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0559444
—
OH
Enumeration date
05/23/2007
Last updated
08/22/2020
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