Organization
UPPER ARLINGTON - BRYAN BASOM DDS LLC
Active
Other names
Magnolia Dental at Kingsdale, Magnolia Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN BASOM DDS (OWNER)
(614) 406-7187
Entity
Organization
Contact information
Practice address
1840 ZOLLINGER RD, COLUMBUS, OH 43221-2850
(614) 457-3927
(614) 457-0668
Mailing address
7870 OLENTANGY RIVER RD STE 205, COLUMBUS, OH 43235-1319
(614) 436-0316
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30.022613
OH
Other
Enumeration date
10/05/2017
Last updated
06/16/2018
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