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500 S Jefferson Ave Plain City OH 43064-4137 | |
(614) 733-0800 | |
Not Available |
Full Name | |
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Speciality | Dentist |
Location | 500 S Jefferson Ave, Plain City, Ohio |
Authorized Official Name and Position | Alisha Gray (VICE PRESIDENT) |
Authorized Official Contact | 6147330800 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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500 S Jefferson Ave Plain City OH 43064-4137 Ph: (614) 733-0800 | 500 S Jefferson Ave Plain City OH 43064-4137 Ph: (614) 733-0800 |
NPI Number | 1003145558 |
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Provider Enumeration Date | 12/11/2009 |
Last Update Date | 12/11/2009 |
Identifier | Type | State | Issuer |
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1003145558 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | 30-021936 (Ohio) | Primary |