Healthcare Provider Details

I. General information

NPI: 1124108907
Provider Name (Legal Business Name): RONALD B GARVEY DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1914 BETHEL RD
COLUMBUS OH
43220-1802
US

IV. Provider business mailing address

1914 BETHEL RD
COLUMBUS OH
43220-1802
US

V. Phone/Fax

Practice location:
  • Phone: 614-451-1122
  • Fax: 614-451-0091
Mailing address:
  • Phone: 614-451-1122
  • Fax: 614-451-0091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number30--014666
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: