Individual
DR. ALEXANDER JENTES MCILVAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
235 BROAD STREET, WADSWORTH, OH 44281-2112
(330) 335-1563
(330) 335-1564
Mailing address
235 BROAD STREET, WADSWORTH, OH 44281-2112
(330) 335-1563
(330) 335-1564
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30.023708
OH
Other
Enumeration date
06/19/2012
Last updated
06/19/2012
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