Provider Demographics
NPI:1770987828
Name:LAWRENCE COUNTY DENTAL SEALANT PROGRAM
Entity type:Organization
Organization Name:LAWRENCE COUNTY DENTAL SEALANT PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTALHYGIENE
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:MEYERS
Authorized Official - Last Name:CAHAL
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:606-615-0615
Mailing Address - Street 1:2538 W HEARTHSTONE LN
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41102-8070
Mailing Address - Country:US
Mailing Address - Phone:606-615-0615
Mailing Address - Fax:
Practice Address - Street 1:2122 S 8TH ST
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638-2502
Practice Address - Country:US
Practice Address - Phone:740-532-3962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAWRENCE COUNTY HEALTH DEPT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDH8544251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare