# MANRAJ S. BATH, DDS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pickerington Manor Jaw & Facial Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568710655
- **Authorized official:** DR. MANRAJ S. BATH DMD (ORAL & MAXILLOFACIAL SURGEON)
- **Authorized official phone:** (614) 751-7500

## Contact information

- **Practice address:** 1575 CROSS CREEKS BLVD., PICKERINGTON, OH 43147
- **Practice address phone:** (614) 751-7500
- **Practice address fax:** (614) 322-7900
- **Mailing address:** 1575 CROSS CREEKS BLVD, PICKERINGTON, OH 43147
- **Mailing address phone:** (614) 751-7500
- **Mailing address fax:** (614) 322-7900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 20162 | OH | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | 20162 | OH | Yes |

## Other

- **Enumeration date:** 08/21/2012
- **Last updated:** 07/01/2016