# NISONGER DENTAL PROGRAM AT JOHNSTOWN ROAD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265749899
- **Authorized official:** DR. DIEGO SOLIS DDS (CLINIC DIRECTOR)
- **Authorized official phone:** (614) 342-5795

## Contact information

- **Practice address:** 2879 JOHNSTOWN RD, COLUMBUS, OH 43219-1719
- **Practice address phone:** (614) 342-5795
- **Practice address fax:** (614) 342-5804
- **Mailing address:** 2879 JOHNSTOWN RD, COLUMBUS, OH 43219-1719
- **Mailing address phone:** (614) 342-5795
- **Mailing address fax:** (614) 342-5804

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 71000178 | OH | Yes |

## Other

- **Enumeration date:** 09/02/2010
- **Last updated:** 09/02/2010