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General NPI Number Information
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NPI Number | 1588851570
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Entity Type | Individual
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Provider Name | JOHN CHARLES KROMHOUT DMD
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Gender | Male
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Dates
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Enumeration Date | 10/03/2007
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Last Update Date | 10/03/2007
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Provider Practice Location Address
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Address Line | 5770 KARL RD SUITE 100
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City | COLUMBUS
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State | OH
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Zip | 43229-3604
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Country | US
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Telephone | 614-885-9331
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Fax | 614-885-2161
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Provider Business Mailing Address
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Address Line | 5770 KARL RD SUITE 100
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City | COLUMBUS
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State | OH
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Zip | 43229-3604
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Country | US
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Telephone | 614-885-9331
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Fax | 614-885-2161
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 21923
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License Number State | OH
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