MEDICARE: DR. ANGELA MARIE BOHRER DDS

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
1	1223G0001X	General Practice Dentistry	30.027113	OH

General Provider Information

NPI Number	:	1821788407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANGELA MARIE BOHRER DDS

Provider Business Mailing Address
First Line	:	470 VERMONT PL
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43201-3131
Country	:	US
Telephone Number	:	330-419-3040
Fax Number	:

Provider Business Practice Location Address
First Line	:	1225 DUBLIN RD STE 40
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-1024
Country	:	US
Telephone Number	:	614-488-9050
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2023
Last Update Date	:	05/09/2023

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