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General NPI Number Information
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NPI Number | 1992510507
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Entity Type | Organization
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Legal Business Name | OHIO KIDS DENTAL HAMILTON - ROBERTS DMD LLC
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 2889 JOSEPH DR STE C
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City | FAIRFIELD TOWNSHIP
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State | OH
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Zip | 45011-3854
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Country | US
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Telephone | 480-866-8811
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Fax |
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Provider Business Mailing Address
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Address Line | 2889 JOSEPH DR STE C
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City | FAIRFIELD TOWNSHIP
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State | OH
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Zip | 45011-3854
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Country | US
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Telephone | 480-866-8811
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | TERESA ZWICKY
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Credential |
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Telephone | 480-866-8811
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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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