Organization
DENTAL EXPRESS BOARDMAN, TED A SCHUSTER DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY R MAUERMAN (ADMINISTRATIVE DIRECTOR)
(330) 533-3400
Entity
Organization
Contact information
Practice address
6540 SOUTH AVE, BOARDMAN, OH 44512-3651
(330) 533-3400
Mailing address
6540 SOUTH AVE, BOARDMAN, OH 44512-3651
(330) 533-3400
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
30-012873
OH
122300000X
Dentist
30-01955
OH
122300000X
Dentist
30-022882
OH
122300000X
Dentist
30-023087
OH
122300000X
Dentist
30015046
OH
122300000X
Dentist
Primary
30020654
OH
122300000X
Dentist
30022311
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0296166
—
OH
05
—
2966992
—
OH
05
—
2994578
—
OH
Enumeration date
11/19/2009
Last updated
07/20/2010
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