Organization
TIFFIN DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL J MOORE (OFFICE MANAGER)
(419) 447-7337
Entity
Organization
Contact information
Practice address
27 ST LAWRENCE DR, SUITE 109, TIFFIN, OH 44883-8312
(419) 447-7337
(419) 447-7003
Mailing address
27 ST LAWRENCE DR, SUITE 109, TIFFIN, OH 44883-8312
(419) 447-7337
(419) 447-7003
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
30022212
OH
1223P0221X
Pediatric Dentistry
Primary
30018784
OH
Other
Enumeration date
09/21/2010
Last updated
09/21/2010
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