| NPI | 1104019587 |
|---|---|
| Doing Business As | DENTALWORKS OF MEDINA |
| Entity Type | Organization |
| Authorized Contact | RACHEL NITTINGER Manager Credentialing 972-755-0816 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30.017399) |
| 1223G0001X Dentist, General Practice (Licence: OH 30.023258) | |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223P0300X Dentist, Periodontics | |
| 1223P0700X Dentist, Prosthodontics | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2017-10-16 |