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General NPI Number Information
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NPI Number | 1902591209
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Entity Type | Organization
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Legal Business Name | OHIO DENTAL CLINIC
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Dates
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Enumeration Date | 04/11/2023
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Last Update Date | 04/18/2023
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Provider Practice Location Address
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Address Line | 6075 CLEVELAND AVE STE 107
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City | COLUMBUS
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State | OH
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Zip | 43231-2242
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Country | US
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Telephone | 614-899-6600
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Fax | 614-899-9094
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Provider Business Mailing Address
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Address Line | 6075 CLEVELAND AVE STE 107
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City | COLUMBUS
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State | OH
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Zip | 43231-2242
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Country | US
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Telephone | 614-899-6600
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Fax | 614-899-9094
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JANICE CASLOW
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Credential |
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Telephone | 614-899-6600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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