MEDICARE: GROVE CITY ENDODONTICS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics

General Provider Information

NPI Number	:	1851596589
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GROVE CITY ENDODONTICS, INC

Provider Business Mailing Address
First Line	:	4203 GANTZ RD
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-2993
Country	:	US
Telephone Number	:	614-277-9455
Fax Number	:	614-277-9133

Provider Business Practice Location Address
First Line	:	4203 GANTZ RD
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-2993
Country	:	US
Telephone Number	:	614-277-9455
Fax Number	:	614-277-9133

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DAVID ERVIN CLAFFEY IV
Credential	:	D.D.S., M.S.
Telephone Number	:	614-277-9455

Provider Enumeration Date	:	06/21/2007
Last Update Date	:	08/22/2020

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Directions to “GROVE CITY ENDODONTICS, INC ” Practice Location

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