David Henry Dds And Randell Roark Dds Inc., NPI 1497169932
General Practice Dentistry in Mansfield, OH, US

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NPI number: what is it?

The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...

NPI 1497169932
NPI Entity Type Organization
Provider Name David Henry Dds And Randell Roark Dds Inc.
Doing Business As
Enumeration Date September 30, 2009
Last Update Date September 30, 2009
Provider Location Address 1041 Cricket Ln, Mansfield, OH, US
Provider Mailing Address 1041 Cricket Ln, Mansfield, OH, US, 449064105
Is Sole Proprietor? No
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Organization Official

Official Name DR. DDS Randell Scott Roark
Official Position DENTIST/ VICE PRESIDENT
Phone 910-584-6894

Group Taxonomy

Taxonomy Code 193400000X
Taxonomy Name 193400000X SINGLE SPECIALTY GROUP
Definition A business group of one or more individual practitioners, all of who practice with the same area of specialization.

Primary Taxonomy

Taxonomy Code

1223G0001X

Taxonomy Name General Practice Dentistry
Classification

Dentist

Group

Dental Providers

License No. 21772
License State OH
Description A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Other Organization Name

Cricket Lane Dental
Doing Business As

Business Address

David Henry Dds And Randell Roark Dds Inc.
1041 Cricket Ln

Mansfield, OH, US

Phone: 419-526-4249

Mailing Address

David Henry Dds And Randell Roark Dds Inc.
1041 Cricket Ln
Mansfield, OH, US
ZIP 449064105
Phone: 419-526-4249

Other Identifiers

Identifier Identifier State Identifier Issuer Type/Code
0076483 OH MEDICAID 05
0489403 OH MEDICAID 05
2860159 OH MEDICAID 05

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1760896260

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