Individual
VIMI MUTALIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
305 W 12TH AVE, ROOM 2195, COLUMBUS, OH 43210-1267
(614) 247-4282
Mailing address
305 W 12TH AVE, ROOM 2195, COLUMBUS, OH 43210-1267
(614) 247-4282
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
RES3634
OH
Other
Enumeration date
08/20/2015
Last updated
08/20/2015
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