Organization
ATHENS COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WENDY CLINE (ADMINISTRATIVE ASSISTANT)
(740) 592-4431
Entity
Organization
Contact information
Practice address
278 W UNION ST, ATHENS, OH 45701-2310
(740) 592-4431
(740) 594-2370
Mailing address
278 W UNION ST, ATHENS, OH 45701-2310
(740) 592-4431
(740) 594-2370
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
—
—
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0464117
—
OH
Enumeration date
01/25/2007
Last updated
05/08/2013
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