Cricket Lane Dental

LBN: David Henry Dds And Randell Roark Dds Inc.
Cricket Lane Dental is an health care organization with primary practice located at 1041 Cricket Ln , Mansfield OH 44906-4105. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. David Henry Dds And Randell Roark Dds Inc. can be contacted via phone (419) 526-4249, or through Roark, Randell Scott via phone (910) 584-6894.

Contact Information

Primary practice address
1041 Cricket Ln Mansfield OH 44906-4105
Phone: (419) 526-4249
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Roark, Randell Scott Doctor of Dental Surgery (DDS)
Phone: (910) 584-6894

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 21772 Ohio

Profile Details

NPI number 1497169932
LBN Legal business name David Henry Dds And Randell Roark Dds Inc.
DBA Doing business as Cricket Lane Dental
Authorized official Roark, Randell Scott Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 12th, 2014
Last updated Jun 12th, 2014 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497169932 NPPES
Ohio MEDICAID 0076483
Ohio MEDICAID 0489403
Ohio MEDICAID 2860159

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