Provider Demographics
NPI:1639231988
Name:RELLE, FERENC
Entity Type:Individual
Prefix:
First Name:FERENC
Middle Name:
Last Name:RELLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1706 BEALL AVE STE D
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-2378
Mailing Address - Country:US
Mailing Address - Phone:330-264-8623
Mailing Address - Fax:
Practice Address - Street 1:1706 BEALL AVE STE D
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-2378
Practice Address - Country:US
Practice Address - Phone:330-264-8623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0221961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice