Provider Demographics
NPI:1699852830
Name:PRIORITY DENTAL INC
Entity Type:Organization
Organization Name:PRIORITY DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:SKLENAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-773-4066
Mailing Address - Street 1:622 CENTRAL CENTER
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601
Mailing Address - Country:US
Mailing Address - Phone:740-775-4222
Mailing Address - Fax:740-772-7104
Practice Address - Street 1:622 CENTRAL CENTER
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601
Practice Address - Country:US
Practice Address - Phone:740-775-4222
Practice Address - Fax:740-772-7104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0600764Medicaid
OH2663336Medicaid