Organization
DENTKOS ENDODONTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERENCE ROBERT DENTKOS DDS, MS (SOLE MEMBER)
(330) 419-0044
Entity
Organization
Contact information
Practice address
16626 PEARL RD, STRONGSVILLE, OH 44136
(330) 419-0044
Mailing address
16626 PEARL RD, STRONGSVILLE, OH 44136
(330) 419-0044
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
3002020607
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912164088
INDIVIDUAL NPI
OH
Enumeration date
08/29/2012
Last updated
08/29/2012
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