Organization
WOMACK DAYTON PEDIATRIC DENTISTRY INC
Active
Other names
Dayton Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GORDON W WOMACK DDS (OWNER)
(937) 641-5098
Entity
Organization
Contact information
Practice address
1 CHILDRENS PLZ, SUITE 2070, DAYTON, OH 45404-1898
(937) 641-5098
(937) 641-5448
Mailing address
1 CHILDRENS PLAZA, SUITE 2070, DAYTON, OH 45404
(937) 641-3455
(937) 641-5448
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
17287
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0617587
—
OH
Enumeration date
01/24/2007
Last updated
08/22/2020
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