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1161 Bethel Rd Suite 303 Columbus OH 43220-2775 | |
| (614) 457-9337 | |
| (614) 705-1867 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 1161 Bethel Rd Suite 303, Columbus, Ohio |
| Authorized Official Name and Position | David A Smeltzer (OWNER) |
| Authorized Official Contact | 6144579337 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1151 Bethel Rd Ste 104 Columbus OH 43220-2775 Ph: (614) 457-9337 | 1161 Bethel Rd Suite 303 Columbus OH 43220-2775 Ph: (614) 457-9337 |
| NPI Number | 1033389382 |
|---|---|
| Provider Enumeration Date | 03/03/2008 |
| Last Update Date | 04/12/2022 |
| Medicare PECOS PAC ID | 4789605312 |
|---|---|
| Medicare Enrollment ID | O20051212000317 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033389382 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 30021594 (Ohio) | Secondary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 30020297 (Ohio) | Primary |
| Provider Name | Gregory Ness |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1528037413 PECOS PAC ID: 3870521123 Enrollment ID: I20111121000520 |
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