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General NPI Number Information
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NPI Number | 1295013407
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Entity Type | Individual
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Provider Name | THILANI MANJULA RODRIGO DDS
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Gender | Female
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Dates
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Enumeration Date | 07/22/2011
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Last Update Date | 07/22/2011
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Provider Practice Location Address
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Address Line | 4044 MORSE RD
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City | COLUMBUS
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State | OH
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Zip | 43230-1448
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Country | US
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Telephone | 614-473-0400
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Fax |
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Provider Business Mailing Address
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Address Line | 3931 OAKPARK PL
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City | CINCINNATI
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State | OH
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Zip | 45209-2119
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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 |
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Name |
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Credential |
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Telephone |
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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 | 30-023541
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License Number State | OH
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