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General NPI Number Information
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NPI Number | 1790821569
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Entity Type | Organization
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Legal Business Name | KENTON DENTAL CARE SALIBA FLEMING & HOLLAND LLC
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3674 NORTH HIGH ST
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City | COLUMBUS
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State | OH
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Zip | 43214
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Country | US
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Telephone | 614-263-4040
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Fax | 614-267-7075
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Provider Business Mailing Address
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Address Line | 121 NORTH DETROIT STREET
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City | KENTON
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State | OH
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Zip | 43326
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Country | US
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Telephone | 419-673-0706
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Fax | 419-673-0725
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Authorized Official
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Title or Position | DENTIST
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Name | COURTNEY W FLEMING
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Credential | DDS
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Telephone | 419-673-0706
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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 | 30021749
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License Number State | OH
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