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General NPI Number Information
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NPI Number | 1225860083
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Entity Type | Organization
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Legal Business Name | MCKOY DENTAL CENTER
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Dates
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Enumeration Date | 08/19/2024
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 1313 E BROAD ST STE 102
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City | COLUMBUS
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State | OH
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Zip | 43205-3510
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Country | US
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Telephone | 614-252-1119
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Fax | 614-252-1265
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Provider Business Mailing Address
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Address Line | 1313 E BROAD ST STE 102
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City | COLUMBUS
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State | OH
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Zip | 43205-3510
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Country | US
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Telephone | 614-252-1119
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Fax | 614-252-1265
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Authorized Official
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Title or Position | DDS / OWNER
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Name | VICTOR MCKOY
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Credential | DDS
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Telephone | 614-252-1119
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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 |
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License Number State |
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