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NPI Code Detail

MEDICARE: OHIO DENTAL PROFESSIONALS WORKMAN, PC

MEDICARE: OHIO DENTAL PROFESSIONALS WORKMAN, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1083834303
Entity Type Code : Organization
Provider Name (Legal Business Name) : OHIO DENTAL PROFESSIONALS WORKMAN, PC
Provider Business Mailing Address
First Line : 3645 STONECREEK BLVD STE 1
Second Line :
City : CINCINNATI
State : OH
Zip : 45251-1459
Country : US
Telephone Number : 513-741-7281
Fax Number : 513-741-7581
Provider Business Practice Location Address
First Line : 3645 STONECREEK BLVD STE 1
Second Line :
City : CINCINNATI
State : OH
Zip : 45251-1459
Country : US
Telephone Number : 513-741-7281
Fax Number : 513-741-7581
Authorized Official
Title or Position : CREDENTIALING COORDINATOR
Name : KENDRA WALKER
Credential :
Telephone Number : 217-540-5100
Provider Enumeration Date : 04/27/2007
Last Update Date : 05/09/2014

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Directions to “OHIO DENTAL PROFESSIONALS WORKMAN, PC ” Practice Location

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