Grand Lake Family Dentistry, Ltd. in Celina - Dentist
Grand Lake Family Dentistry, Ltd. - NPI 1952428310
Grand Lake Family Dentistry, Ltd. is a Dentist in Celina, Ohio. Grand Lake Family Dentistry, Ltd. practices all healthcare services and medical treatments related to Dentist. The NPI Number for Grand Lake Family Dentistry, Ltd. is 1952428310. The last update date is 2012-12-20.
Grand Lake Family Dentistry, Ltd.'s current location address is 800 E Wayne St, Celina, Ohio. You can contact this provider via phone number 4195861615 and fax number 4195861616. The mailing address for Grand Lake Family Dentistry, Ltd. is 800 E Wayne St, Celina, Ohio. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Grand Lake Family Dentistry, Ltd. |
|---|---|
| Address | 800 E Wayne St, Celina, Ohio |
| Phone Number | 4195861615 |
| Fax Number | 4195861616 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Lutz Duane Travis |
| Credentials | DDS |
| Telephone Number | 4195861615 |
NPI Number Detail
| NPI Number | 1952428310 |
|---|---|
| Provider Enumeration Date | 2007-03-23 |
| Last Updated Date | 2012-12-20 |
Provider Mailing Address Detail
| Address | 800 E Wayne St |
|---|---|
| City | Celina |
| State | Ohio (OH) |
| Post Code | 458221359 |
| Phone Number | 4195861615 |
| Fax Number | 4195861616 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 30.020826 |
|
Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 9182631 | DENTAQUEST | ||
| 2057965 | OH | -- | |
| 6131 | PARAMOUNT |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Grand Lake Family Dentistry, Ltd. by the Centers for Medicare & Medicaid Services?
The Grand Lake Family Dentistry, Ltd. has been assigned the NPI (National Provider Identifier) 1952428310 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please share the complete physical address where Grand Lake Family Dentistry, Ltd. is geographically located?
The Grand Lake Family Dentistry, Ltd. is physically situated at the following location: 800 E Wayne St, Celina, OH, 458221359.
What is Grand Lake Family Dentistry, Ltd.'s specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Grand Lake Family Dentistry, Ltd.'s specialized field of practice is Dentist, and the corresponding taxonomy code that categorizes this area of specialization is 122300000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1952428310 to Grand Lake Family Dentistry, Ltd.?
The Centers for Medicare & Medicaid Services originally issued the 1952428310 to Grand Lake Family Dentistry, Ltd. on 2007-03-23.
As of what date was the information pertaining to Grand Lake Family Dentistry, Ltd., such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Grand Lake Family Dentistry, Ltd., including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2012-12-20.