Provider Demographics
NPI:1124121728
Name:ENDODONTICS LIMITED INC
Entity type:Organization
Organization Name:ENDODONTICS LIMITED INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:DEVENGENCIE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:440-686-3636
Mailing Address - Street 1:25111 COUNTRY CLUB BLVD
Mailing Address - Street 2:STE 201
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070
Mailing Address - Country:US
Mailing Address - Phone:440-686-3636
Mailing Address - Fax:440-686-3637
Practice Address - Street 1:25111 COUNTRY CLUB BLVD
Practice Address - Street 2:STE 201
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070
Practice Address - Country:US
Practice Address - Phone:440-686-3636
Practice Address - Fax:440-686-3637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300199021223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty