Organization
ELLERHORST DENTAL, LLC
Active
Other names
Ellerhorst Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYDIA ELLERHORST DDS (DENTIST/OWNER)
(330) 221-4270
Entity
Organization
Contact information
Practice address
10730 MAIN ST APT 2, MANTUA, OH 44255-8951
(330) 274-3495
Mailing address
PO BOX 350, MANTUA, OH 44255-0350
(330) 221-4270
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/17/2024
Last updated
04/17/2024
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