Healthcare Provider Details

I. General information

NPI: 1871003582
Provider Name (Legal Business Name): US DENTAL AND MEDICAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2017
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

949 E LIVINGSTON AVE
COLUMBUS OH
43205-2748
US

IV. Provider business mailing address

949 E LIVINGSTON AVE
COLUMBUS OH
43205-2748
US

V. Phone/Fax

Practice location:
  • Phone: 614-252-3181
  • Fax: 614-252-1549
Mailing address:
  • Phone: 614-252-3181
  • Fax: 614-252-1549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WENDY BRAMAN
Title or Position: MANAGER
Credential:
Phone: 614-252-3181