# QUEEN CITY ORTHODONTICS

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

## Provider details

- **NPI number:** 1609565258
- **Authorized official:** NICOLE CRASTO DDS, MS (ORTHODONTICS)
- **Authorized official phone:** (567) 454-0273

## Contact information

- **Practice address:** 6752 CINCINNATI DAYTON RD STE 102A, LIBERTY TOWNSHIP, OH 45044-9325
- **Practice address phone:** (513) 434-8320
- **Mailing address:** 9856 SNIDER RD, MASON, OH 45040-9323
- **Mailing address phone:** (567) 454-0273

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/01/2023
- **Last updated:** 05/01/2023