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General NPI Number Information
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NPI Number | 1053830547
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Entity Type | Organization
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Legal Business Name | COLUMBUS ORTHODONTIC CENTER AMIN MASON DDS LLC
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Dates
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Enumeration Date | 09/15/2017
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Last Update Date | 09/15/2017
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Provider Practice Location Address
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Address Line | 2 E. LONG STREET
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City | COLUMBUS
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State | OH
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Zip | 43215
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Country | US
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Telephone | 614-549-5835
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Fax |
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Provider Business Mailing Address
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Address Line | 2 E LONG ST
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City | COLUMBUS
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State | OH
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Zip | 43215-2902
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMIN MASON
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Credential |
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Telephone | 614-549-5835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 30.023085
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License Number State | OH
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