Provider Demographics
NPI:1417094475
Name:HOSPITAL DENTAL ASSOCIATES INC
Entity Type:Organization
Organization Name:HOSPITAL DENTAL ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:M
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MAGD FAAHD
Authorized Official - Phone:330-965-9344
Mailing Address - Street 1:721 BOARDMAN POLAND RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-5107
Mailing Address - Country:US
Mailing Address - Phone:330-965-9344
Mailing Address - Fax:330-965-9347
Practice Address - Street 1:721 BOARDMAN POLAND RD
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-5107
Practice Address - Country:US
Practice Address - Phone:330-965-9344
Practice Address - Fax:330-965-9347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH17005122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty