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4044 Morse Rd Columbus OH 43230-1448 | |
| (614) 473-0400 | |
| (913) 800-6967 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4044 Morse Rd, Columbus, Ohio |
| Authorized Official Name and Position | Amy Wheeler (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 9138006952 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 11568 Overland Park KS 66207-4268 Ph: (913) 428-1674 | 4044 Morse Rd Columbus OH 43230-1448 Ph: (614) 473-0400 |
| NPI Number | 1952599276 |
|---|---|
| Provider Enumeration Date | 10/11/2007 |
| Last Update Date | 04/12/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952599276 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 261QD0000X | Clinic/center - Dental | 30-022131 (Ohio) | Primary |
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