Organization
DYNAMIC DENTAL SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER NORMAN BEALE DDS (PRESIDENT)
(419) 610-1620
Entity
Organization
Contact information
Practice address
583 WILES RD, MANFIELD, OH 44903
(419) 610-1620
(419) 756-4886
Mailing address
583 WILES RD, MANFIELD, OH 44903
(419) 610-1620
(419) 756-4886
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0250095
—
OH
Enumeration date
01/11/2024
Last updated
01/11/2024
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