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Organization
UNIVERSITY SURGICAL-DENTAL ASSOCIATES, LLC
Active
Organization
UNIVERSITY SURGICAL-DENTAL ASSOCIATES, LLC
Active
Other names
University Surgical Dental Associates, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
HUGH HINDS (EXECUTIVE VP/CFO)
(513) 585-8720
Entity
Organization
Contact information
Practice address
222 PIEDMONT AVE., CINCINNATI, OH 45219-4231
(513) 475-8783
(513) 475-7698
Mailing address
3200 BURNET AVE, 3 SOUTH, CREDENTIALING, CINCINNATI, OH 45229-3019
(513) 585-5502
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0404048
—
OH
Enumeration date
01/27/2006
Last updated
09/16/2019
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