| Nisonger Dental Program At Johnstown Road | |
|
2879 Johnstown Rd Columbus OH 43219-1719 | |
| (614) 342-5795 | |
| (614) 342-5804 |
| Full Name | Nisonger Dental Program At Johnstown Road |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2879 Johnstown Rd, Columbus, Ohio |
| Authorized Official Name and Position | Diego Solis (CLINIC DIRECTOR) |
| Authorized Official Contact | 6143425795 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nisonger Dental Program At Johnstown Road 2879 Johnstown Rd Columbus OH 43219-1719 Ph: (614) 342-5795 | Nisonger Dental Program At Johnstown Road 2879 Johnstown Rd Columbus OH 43219-1719 Ph: (614) 342-5795 |
| NPI Number | 1265749899 |
|---|---|
| Provider Enumeration Date | 09/02/2010 |
| Last Update Date | 09/02/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265749899 | NPI | - | NPPES |
| 2671087 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 71000178 (Ohio) | Primary |
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