Provider Demographics
NPI:1689030652
Name:NANETTE C TERTEL, DDS, INC.
Entity Type:Organization
Organization Name:NANETTE C TERTEL, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NANETTE
Authorized Official - Middle Name:C
Authorized Official - Last Name:TERTEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:419-478-8685
Mailing Address - Street 1:3953 WALLWERTH DR
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43612-1128
Mailing Address - Country:US
Mailing Address - Phone:419-478-8685
Mailing Address - Fax:419-478-8760
Practice Address - Street 1:3953 WALLWERTH DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43612-1128
Practice Address - Country:US
Practice Address - Phone:419-478-8685
Practice Address - Fax:419-478-8760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-18795261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental