Organization
GREATER COLUMBUS PERIODONTICS, LLC, RYAN J. SERRA, DMD, MS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN SERRA D.M.D., M.S. (MEMBER)
(614) 451-1122
Entity
Organization
Contact information
Practice address
1914 BETHEL RD, COLUMBUS, OH 43220-1802
(614) 451-1122
Mailing address
1914 BETHEL RD, COLUMBUS, OH 43220-1802
(614) 451-1122
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
014666
OH
1223P0300X
Periodontics
Primary
023093
OH
Other
Enumeration date
09/22/2009
Last updated
09/22/2009
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