Organization
TUSCARAWAS ORAL & MAXILLOFACIAL SURGERY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. C. RANDALL DOAN DDS (PRESIDENT)
(330) 364-8665
Entity
Organization
Contact information
Practice address
1456 KADERLY ST NW, NEW PHILADELPHIA, OH 44663-1243
(330) 364-8665
(330) 364-8667
Mailing address
1456 KADERLY ST NW, NEW PHILADELPHIA, OH 44663-1243
(330) 364-8665
(330) 364-8667
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
OH
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0882086
—
OH
Enumeration date
03/01/2006
Last updated
02/08/2011
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