Organization
ALEXANDER J MCILVAINE DMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEXANDER JENTES MCILVAINE DMD (SOLE MEMBER)
(330) 414-4083
Entity
Organization
Contact information
Practice address
235 BROAD ST, WADSWORTH, OH 44281-2112
(330) 335-1563
(330) 335-1563
Mailing address
235 BROAD ST, WADSWORTH, OH 44281-2112
(330) 335-1563
(330) 335-1563
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30-023708
OH
Other
Enumeration date
05/12/2015
Last updated
05/12/2015
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