Organization
JUDIS ALUMCREEK DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY M JUDIS DDS (OWNER)
(614) 409-9404
Entity
Organization
Contact information
Practice address
4016 ALUM CREEK DR, COLUMBUS, OH 43207-5137
(614) 409-9404
(614) 409-2992
Mailing address
4016 ALUM CREEK DR, COLUMBUS, OH 43207-5137
(614) 409-9404
(614) 409-2992
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
022588
OH
122300000X
Dentist
Primary
19680
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2039305
—
OH
05
—
2940894
—
OH
Enumeration date
09/13/2011
Last updated
09/13/2011
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