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885 W 3rd Ave Columbus OH 43212-3106 | |
| (614) 505-7027 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 885 W 3rd Ave, Columbus, Ohio |
| Authorized Official Name and Position | Jessica Bowersock (TREATMENT COORDINATOR) |
| Authorized Official Contact | 6145057027 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
885 W 3rd Ave Columbus OH 43212-3106 Ph: () - | 885 W 3rd Ave Columbus OH 43212-3106 Ph: (614) 505-7027 |
| NPI Number | 1285186932 |
|---|---|
| Provider Enumeration Date | 10/28/2016 |
| Last Update Date | 10/28/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285186932 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 30.022887 (Ohio) | Primary |
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