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General NPI Number Information
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NPI Number | 1609421684
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Entity Type | Organization
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Legal Business Name | COLUMBUS ENDODONTIC SPECIALISTS
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Dates
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Enumeration Date | 08/06/2019
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Last Update Date | 08/06/2019
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Provider Practice Location Address
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Address Line | 7334 E BROAD ST STE C
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City | BLACKLICK
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State | OH
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Zip | 43004-9239
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Country | US
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Telephone | 614-577-1100
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Fax | 614-577-1348
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Provider Business Mailing Address
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Address Line | 7334 E BROAD ST STE C
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City | BLACKLICK
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State | OH
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Zip | 43004-9239
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Country | US
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Telephone | 614-577-1100
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Fax | 614-577-1348
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. LISA K HUNTER
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Credential |
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Telephone | 614-577-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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