Healthcare Provider Details

I. General information

NPI: 1558770222
Provider Name (Legal Business Name): MORSE DENTAL HEALTH CENTER JOAN SALIDO DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2014
Last Update Date: 08/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4655 MORSE CENTRE RD
COLUMBUS OH
43229-6601
US

IV. Provider business mailing address

4655 MORSE CENTRE RD
COLUMBUS OH
43229-6601
US

V. Phone/Fax

Practice location:
  • Phone: 614-470-9840
  • Fax: 614-470-9841
Mailing address:
  • Phone: 614-470-9840
  • Fax: 614-470-9841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number20877
License Number StateOH

VIII. Authorized Official

Name: JOAN SALIDO
Title or Position: OWNER
Credential:
Phone: 614-470-9840