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General NPI Number Information
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NPI Number | 1255331328
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Entity Type | Organization
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Legal Business Name | UNIVERSITY ORAL PATHOLOGY
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Dates
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Enumeration Date | 07/29/2005
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 222 PIEDMONT AVE STE 8400
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City | CINCINNATI
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State | OH
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Zip | 45219-4231
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Country | US
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Telephone | 513-965-8041
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Fax | 513-965-8091
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Provider Business Mailing Address
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Address Line | PO BOX 42262
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City | CINCINNATI
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State | OH
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Zip | 45242-0262
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Country | US
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Telephone | 513-965-8091
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Fax | 513-965-8091
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Authorized Official
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Title or Position | CLIENT SERVICES MANAGER
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Name | LYNN GRAY
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Credential |
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Telephone | 513-965-8041
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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