Organization
MECKLER DENTAL PROVIDERS (OLMSTED), INC
Active
Parent organization
DENTALONE PARTNERS, INC
Other names
DentalWorks of North Olmsted, DentalWorks
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTALONE PARTNERS, INC
Authorized official
KATHLEEN STAUTIHAR (SUPERVISOR, CREDENTIALING)
(216) 584-1673
Entity
Organization
Contact information
Practice address
4710 GREAT NORTHERN BLVD, NORTH OLMSTED, OH 44070-3427
(440) 716-6939
(216) 584-1004
Mailing address
PO BOX 860036, MINNEAPOLIS, MN 55486-0036
(440) 734-6500
(216) 584-1004
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
30.017994
OH
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
02/07/2006
Last updated
10/19/2018
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