Provider Demographics
NPI:1982646287
Name:EARNEY DENTAL ASSOCIATES INC
Entity Type:Organization
Organization Name:EARNEY DENTAL ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:W
Authorized Official - Last Name:EARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD PHD
Authorized Official - Phone:330-674-8080
Mailing Address - Street 1:135 SOUTH CLAY ST
Mailing Address - Street 2:
Mailing Address - City:MILLERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44654
Mailing Address - Country:US
Mailing Address - Phone:330-674-8080
Mailing Address - Fax:330-674-4837
Practice Address - Street 1:135 SOUTH CLAY ST
Practice Address - Street 2:
Practice Address - City:MILLERSBURG
Practice Address - State:OH
Practice Address - Zip Code:44654
Practice Address - Country:US
Practice Address - Phone:330-674-8080
Practice Address - Fax:330-674-4837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH155971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH6648470001Medicare NSC