Healthcare Provider Details

I. General information

NPI: 1265662944
Provider Name (Legal Business Name): BRITTANY LEIGH DEXTER D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2009
Last Update Date: 03/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9745 FAIRWAY DRIVE
POWELL OH
43065
US

IV. Provider business mailing address

9745 FAIRWAY DRIVE
POWELL OH
43065
US

V. Phone/Fax

Practice location:
  • Phone: 614-766-5722
  • Fax: 614-754-5219
Mailing address:
  • Phone: 614-766-5722
  • Fax: 614-754-5219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30.023081
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: