Provider Demographics
NPI:1841417250
Name:OHIO VALLEY DENTAL CARE LLC
Entity Type:Organization
Organization Name:OHIO VALLEY DENTAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:T
Authorized Official - Last Name:NOGLE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:937-544-5591
Mailing Address - Street 1:114 W NORTH ST
Mailing Address - Street 2:
Mailing Address - City:WEST UNION
Mailing Address - State:OH
Mailing Address - Zip Code:45693-1021
Mailing Address - Country:US
Mailing Address - Phone:937-544-5591
Mailing Address - Fax:937-544-5448
Practice Address - Street 1:114 W NORTH ST
Practice Address - Street 2:
Practice Address - City:WEST UNION
Practice Address - State:OH
Practice Address - Zip Code:45693-1021
Practice Address - Country:US
Practice Address - Phone:937-544-5591
Practice Address - Fax:937-544-5448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0215341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty