Provider Demographics
NPI:1609966548
Name:WINSLOW, DOUGLAS PAUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:PAUL
Last Name:WINSLOW
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23525 DETROIT RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-1638
Mailing Address - Country:US
Mailing Address - Phone:440-331-8808
Mailing Address - Fax:440-331-2368
Practice Address - Street 1:23525 DETROIT RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-1638
Practice Address - Country:US
Practice Address - Phone:440-331-8808
Practice Address - Fax:440-331-2368
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH179681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice