Organization
THIRD STREET COMMUNITY CLINIC, INC.
Active
Other names
9th Street Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
PEGGY ANDERSON (CEO)
(419) 522-6191
Entity
Organization
Contact information
Practice address
431 E 9TH ST, ASHLAND, OH 44805-1903
(419) 289-1430
(419) 525-6723
Mailing address
1404 PARK AVE W, STE 2, MANSFIELD, OH 44906-2633
(419) 522-6191
(419) 525-6723
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
01/23/2020
Last updated
10/29/2024
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