Individual
LEAH ROSALYN TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5770 KARL RD, SUITE 100, COLUMBUS, OH 43229-3604
(614) 846-8340
(614) 846-8345
Mailing address
5770 KARL RD, SUITE 100, COLUMBUS, OH 43229-3604
(614) 846-8340
(614) 846-8345
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30022450
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2682039
MOLINA
OH
05
—
2682039
—
OH
Enumeration date
12/15/2006
Last updated
06/11/2012
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