Organization
OHIO NORTH EAST HEALTH SYSTEMS INC
Active
Other names
NORTHSIDE DENTAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD DWINNELLS MD (CEO)
(330) 747-9551
Entity
Organization
Contact information
Practice address
500 GYPSY LANE, MEDICAL OFFICE BLDG A, YOUNGSTOWN, OH 44504-1315
(877) 722-3303
(330) 884-6120
Mailing address
726 WICK AVE, YOUNGSTOWN, OH 44505-2827
(330) 747-9551
(330) 884-6120
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
124Q00000X
Dental Hygienist
—
—
261Q00000X
Clinic/Center
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/28/2019
Last updated
03/28/2019
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