| Elemental Dental - Sonya R. Moesle Dds, Llc | |
|
686 Corylus Dr Pataskala OH 43062-7628 | |
| (740) 964-3500 | |
| (740) 964-3502 |
| Full Name | Elemental Dental - Sonya R. Moesle Dds, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 686 Corylus Dr, Pataskala, Ohio |
| Authorized Official Name and Position | Sonya Renee Moesle (PRINCIPAL) |
| Authorized Official Contact | 7409643500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elemental Dental - Sonya R. Moesle Dds, Llc 686 Corylus Dr Pataskala OH 43062-7628 Ph: (740) 964-3500 | Elemental Dental - Sonya R. Moesle Dds, Llc 686 Corylus Dr Pataskala OH 43062-7628 Ph: (740) 964-3500 |
| NPI Number | 1700576113 |
|---|---|
| Provider Enumeration Date | 05/09/2023 |
| Last Update Date | 05/09/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700576113 | NPI | - | NPPES |
| 1689975005 | Other | INDIVIDUAL NPI | |
| 30.020362 | Other | OH | OHIO DENTAL LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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