Organization
BELLEFONTAINE DENTAL, MARK R. BEDFORD, DDS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY S NELSON (PRACTICE MANAGER)
(937) 206-4080
Entity
Organization
Contact information
Practice address
4 W MAIN ST, SUITE 908, SPRINGFIELD, OH 45502-1300
(937) 322-7832
(937) 322-7946
Mailing address
137 W CHILLICOTHE AVE, BELLEFONTAINE, OH 43311-1472
(937) 592-1776
(937) 592-4566
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
15902
OH
Other
Enumeration date
06/06/2011
Last updated
06/06/2011
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