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General NPI Number Information
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NPI Number | 1154532778
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Entity Type | Organization
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Legal Business Name | CLASSIC MOBILE DENTAL SERVICES-CYNTHIA TUFTS WHITE D.D.S., INC
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 10/05/2016
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Provider Practice Location Address
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Address Line | 2213 INCHCLIFF RD
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City | COLUMBUS
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State | OH
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Zip | 43221-2715
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Country | US
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Telephone | 614-395-1870
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Fax | 614-319-6144
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Provider Business Mailing Address
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Address Line | PO BOX 20671
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City | COLUMBUS
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State | OH
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Zip | 43220-0671
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Country | US
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Telephone | 614-395-1870
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Fax | 614-319-6144
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Authorized Official
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Title or Position | PRESIDENT, OWNER
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Name | DR. CYNTHIA TUFTS WHITE
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Credential | DDS
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Telephone | 614-395-1870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 31.019945
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License Number State | OH
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