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General NPI Number Information
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NPI Number | 1639404544
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Entity Type | Organization
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Legal Business Name | DNA DIAGNOSTICS CENTER
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Dates
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Enumeration Date | 10/09/2009
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Last Update Date | 09/06/2011
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Provider Practice Location Address
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Address Line | ONE DDC WAY
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City | FAIRFIELD
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State | OH
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Zip | 45014-2296
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Country | US
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Telephone | 513-881-7800
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Fax | 513-881-7803
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Provider Business Mailing Address
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Address Line | 1 DDC WAY
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City | FAIRFIELD
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State | OH
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Zip | 45014-2281
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Country | US
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Telephone | 513-881-7800
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Fax | 513-881-7803
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Authorized Official
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Title or Position | ASSOCIATE VICE PRESIDENT
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Name | DR. MICHAEL BAIRD
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Credential |
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Telephone | 513-881-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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