| Pickaway General Dentistry | |
|
1422 Circleville Plaza Dr Circleville OH 43113-2269 | |
| (614) 530-6558 | |
| (614) 262-2883 |
| Full Name | Pickaway General Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1422 Circleville Plaza Dr, Circleville, Ohio |
| Authorized Official Name and Position | Robert W. Gardner (PARTNER/MEMBER) |
| Authorized Official Contact | 6145306558 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pickaway General Dentistry 1422 Circleville Plaza Dr Circleville OH 43113-2269 Ph: (614) 530-6558 | Pickaway General Dentistry 1422 Circleville Plaza Dr Circleville OH 43113-2269 Ph: (614) 530-6558 |
| NPI Number | 1477887958 |
|---|---|
| Provider Enumeration Date | 09/30/2009 |
| Last Update Date | 09/30/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477887958 | NPI | - | NPPES |
| 0978483 | Medicaid | OH | |
| 0212577 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 30020068 (Ohio) | Primary |
| 1223G0001X | Dentist - General Practice | 30020074 (Ohio) | Secondary |
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Premier Dental Of Circleville Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1422 Circleville Plaza Dr, Circleville, OH 43113 Phone: 740-474-6900 | |
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