Duane Thomas Cole, DDS
Individual provider Active NPI Dentist · Conneaut, OH
NPI 1891904082 · NPPES record last updated Apr 24, 2024
Key facts
- NPI
- 1891904082
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 30019211 (OH)
- Practice address
- 277 Gore Rd
Conneaut, OH 44030-2907 - Phone
- (440) 599-2370
- Fax
- (440) 599-9170
- NPI assigned
- May 22, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30019211 | OH | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS038223 | PA | |
| Dentist | 122300000X | 30019211 | OH | Yes |
Addresses
Primary practice location
277 Gore Rd
Conneaut, OH 44030-2907
Mailing address
277 Gore Rd
Conneaut, OH 44030-2907
Phone (440) 599-2370
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1024482690001 | Medicaid | PA |
Other providers in Conneaut, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.