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55 Caren Ave Ste 270 Worthington OH 43085-2515 | |
| (614) 888-7012 | |
| (614) 888-0284 |
| Full Name | |
|---|---|
| Speciality | Dentist - Prosthodontics |
| Location | 55 Caren Ave Ste 270, Worthington, Ohio |
| Authorized Official Name and Position | Bradley A Purcell (OWNER/DENTIST) |
| Authorized Official Contact | 6148854249 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
55 Caren Ave Ste 270 Worthington OH 43085-2515 Ph: (614) 888-7012 | 55 Caren Ave Ste 270 Worthington OH 43085-2515 Ph: (614) 888-7012 |
| NPI Number | 1912250135 |
|---|---|
| Provider Enumeration Date | 10/25/2012 |
| Last Update Date | 11/05/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912250135 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0700X | Dentist - Prosthodontics | 15174 (Michigan) | Primary |
| 1223P0700X | Dentist - Prosthodontics | 22655 (Illinois) | Secondary |
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