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460 W 10th Ave Fl 5 Columbus OH 43210-1240 | |
| (614) 293-8074 | |
| (614) 293-3193 |
| Full Name | |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 460 W 10th Ave Fl 5, Columbus, Ohio |
| Authorized Official Name and Position | Jami Hensley (ADMINISTRATIVE DIRECTOR) |
| Authorized Official Contact | 6142932229 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
700 Ackerman Rd Ste 2120 Columbus OH 43202-1559 Ph: (614) 685-4601 | 460 W 10th Ave Fl 5 Columbus OH 43210-1240 Ph: (614) 293-8074 |
| NPI Number | 1881087112 |
|---|---|
| Provider Enumeration Date | 03/11/2015 |
| Last Update Date | 02/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881087112 | NPI | - | NPPES |
| 0121379 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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