BOWLING GREEN PEDIATRIC DENTAL GROUP INC NPI 1477611333

NPI Information

NPI: 1477611333
Provider Name: BOWLING GREEN PEDIATRIC DENTAL GROUP INC
Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
1221 RIDGEWOOD DRIVE
SUITE B
BOWLING GREEN, OH
ZIP 43402
Phone: (419) 352-2593
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BOWLING GREEN PEDIATRIC DENTAL GROUP INC is a pediatric dentistry dentist in Bowling Green, OH. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. BOWLING GREEN PEDIATRIC DENTAL GROUP INC NPI is 1477611333. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1221 RIDGEWOOD DRIVE
SUITE B
BOWLING GREEN, OH
ZIP 43402-667
Phone: (419) 352-2593
Fax: (419) 354-4717

The provider's authorized official is Frank Louis Pace .
The authorized official title is President and has the following contact phone number (419) 352-2593.

The enumeration date for this NPI number is 12/4/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223P0221X	Dentist	Pediatric Dentistry	30014316	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0587262	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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