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General NPI Number Information
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NPI Number | 1790302081
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Entity Type | Organization
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Legal Business Name | TOPS ORTHODONTICS, L.L.C.
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Dates
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Enumeration Date | 07/02/2020
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Last Update Date | 08/18/2020
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Provider Practice Location Address
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Address Line | 163 N SANDUSKY ST LOWR L-100
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City | DELAWARE
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State | OH
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Zip | 43015-1785
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Country | US
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Telephone | 740-363-0886
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Fax |
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Provider Business Mailing Address
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Address Line | 163 N SANDUSKY ST LOWR L-100
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City | DELAWARE
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State | OH
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Zip | 43015-1785
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Country | US
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Telephone | 740-363-0886
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. DAHYE JOO
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Credential | D.M.D., M.S.D.
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Telephone | 740-368-0886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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