Organization
MECKLER DENTAL PROVIDERS (GREAT LAKES), INC.
Active
Parent organization
DENTALONE PARTNERS, INC
Other names
' DentalWorks of Great Lakes '
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTALONE PARTNERS, INC
Authorized official
RACHEL NITTINGER (MANAGER CREDENTIALING)
(972) 755-0816
Entity
Organization
Contact information
Practice address
36173 EUCLID AVE, WILLOUGHBY, OH 44094-4410
(440) 255-5631
Mailing address
7160 DALLAS PKWY STE 400, PLANO, TX 75024-7111
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
04/11/2006
Last updated
03/17/2018
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