Organization
FOUNDATION DENTAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN FREDERICK PETERS D.M.D. (OWNER)
(330) 875-2200
Entity
Organization
Contact information
Practice address
309 S CHAPEL ST, LOUISVILLE, OH 44641-1612
(330) 875-2200
(330) 875-2403
Mailing address
309 S CHAPEL ST, LOUISVILLE, OH 44641-1612
(330) 875-2200
(330) 875-2403
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
020417
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2843712
—
OH
Enumeration date
08/13/2008
Last updated
10/15/2008
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