Organization
GRUELLE ISON ORTHODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN J ISON (PARTNER)
(513) 772-6500
Entity
Organization
Contact information
Practice address
9825 COLERAIN AVE STE 300, CINCINNATI, OH 45251-1554
(513) 772-6500
(513) 772-2002
Mailing address
4845 RIALTO RD STE A, WEST CHESTER, OH 45069-2910
(513) 772-6500
(513) 772-2002
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
01/16/2020
Last updated
02/06/2020
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