Organization
DYNAMIC DENTAL SPECIALISTS, LLC
Active
Organization
DYNAMIC DENTAL SPECIALISTS, LLC
Active
Other names
Dynamic Dental Specialists, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER BEALE DDS (PRESIDENT)
(248) 346-4809
Entity
Organization
Contact information
Practice address
630 LEXINGTON AVE, MANSFIELD, OH 44907-1500
(419) 756-0711
Mailing address
1535 PINE GROVE CT, MANSFIELD, OH 44906-3519
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0250095
—
OH
Enumeration date
04/29/2020
Last updated
04/29/2020
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