Organization
ENDODONTIC ASSOCIATES OF NWO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN BYRON MIKESELL DDS MS (PRESIDENT MEMBER)
(419) 738-6944
Entity
Organization
Contact information
Practice address
715 N DIXIE, WAPAKONETA, OH 45895-0024
(419) 738-6944
(419) 738-1444
Mailing address
PO BOX 24, 715 N DIXIE, WAPAKONETA, OH 45895-0024
(419) 738-6944
(419) 738-1444
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
30012922
OH
1223E0200X
Endodontics
30021456
OH
1223E0200X
Endodontics
30021501
OH
Other
Enumeration date
09/06/2006
Last updated
08/22/2020
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