Organization
LOUIS J ALTOMARE & BRYAN J SIMONE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN J SIMONE DDS (PARTNER)
(614) 875-3141
Entity
Organization
Contact information
Practice address
4104 BROADWAY, GROVE CITY, OH 43123-3065
(614) 875-3141
Mailing address
4104 BROADWAY, GROVE CITY, OH 43123
(614) 875-3141
(614) 875-8812
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12620
OH
122300000X
Dentist
Primary
19692
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0893645
—
OH
Enumeration date
03/13/2007
Last updated
08/22/2020
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