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General NPI Number Information
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NPI Number | 1134550882
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Entity Type | Organization
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Legal Business Name | SCARLET DENTAL KATIE VINCER SEARS DDS, INC.
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Dates
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Enumeration Date | 12/05/2013
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Last Update Date | 11/21/2018
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Provider Practice Location Address
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Address Line | 3205 BROADVUE CIRCLE
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City | ZANESVILLE
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State | OH
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Zip | 43701
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Country | US
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Telephone | 740-454-6705
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Fax | 740-454-9388
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Provider Business Mailing Address
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Address Line | 107 W. COLUMBUS STREET
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City | PICKERINGTON
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State | OH
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Zip | 43147
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Country | US
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Telephone | 614-829-7285
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Fax | 614-829-7811
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Authorized Official
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Title or Position | MANAGER
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Name | SUSAN LEE
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Credential |
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Telephone | 614-829-7285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30.022821
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License Number State | OH
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