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Individual

DR. SIMON R. PRIOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS, PHD

Contact information

Practice address
305 W 12TH AVE, DENTAL FACULTY PRACTICE ASSOCIATION, COLUMBUS, OH 43210-1267
(614) 247-0002
Mailing address
305 W 12TH AVE, 2148, POSTLE HALL, COLUMBUS, OH 43210-1267
(614) 247-8014

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
0179
OH
1223D0004X
Dental Anesthesiology
Primary
71-000179
OH
207L00000X
Anesthesiology Physician
71-000179
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2467647
OH
Enumeration date
01/04/2007
Last updated
05/21/2013
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