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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