Organization
ONE GOOD SMILE
Active
Organization
ONE GOOD SMILE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT A VAN HALA DDS (DENTIST)
(330) 929-7344
Entity
Organization
Contact information
Practice address
802 GRAHAM ROAD, CUYAHOGA FALLS, OH 44221-1049
(330) 929-7344
Mailing address
802 GRAHAM RD, CUYAHOGA FALLS, OH 44221-1049
(330) 929-7344
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
30022586
OH
305S00000X
Point of Service
—
—
Other
Enumeration date
07/26/2018
Last updated
07/26/2018
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