Provider Demographics
NPI:1598798613
Name:GREATER OHIO DENTAL SERVICES INC.
Entity Type:Organization
Organization Name:GREATER OHIO DENTAL SERVICES INC.
Other - Org Name:ANDERSON DENTAL CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:JOE
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:419-424-5850
Mailing Address - Street 1:1401 E SANDUSKY ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-6456
Mailing Address - Country:US
Mailing Address - Phone:419-424-5850
Mailing Address - Fax:419-424-0697
Practice Address - Street 1:1401 E SANDUSKY ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-6456
Practice Address - Country:US
Practice Address - Phone:419-424-5850
Practice Address - Fax:419-424-0697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH209151223G0001X
OH218411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty