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General NPI Number Information
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NPI Number | 1952407686
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Entity Type | Organization
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Legal Business Name | OLENTANGY PEDIATRIC DENTISTRY
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 05/23/2024
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Provider Practice Location Address
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Address Line | 525 LIBERTY RD. N
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City | POWELL
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State | OH
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Zip | 43065
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Country | US
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Telephone | 614-433-7474
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Fax | 614-433-9090
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Provider Business Mailing Address
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Address Line | 525 LIBERTY RD. N
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City | POWELL
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State | OH
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Zip | 43065
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Country | US
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Telephone | 614-433-7474
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Fax | 614-433-9090
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY T MILTON
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Credential | DDS MS
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Telephone | 614-433-7474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 21874
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License Number State | OH
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