Organization
NISONGER DENTAL PROGRAM AT JOHNSTOWN ROAD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIEGO SOLIS DDS (CLINIC DIRECTOR)
(614) 342-5795
Entity
Organization
Contact information
Practice address
2879 JOHNSTOWN RD, COLUMBUS, OH 43219-1719
(614) 342-5795
(614) 342-5804
Mailing address
2879 JOHNSTOWN RD, COLUMBUS, OH 43219-1719
(614) 342-5795
(614) 342-5804
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
71000178
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2671087
—
OH
Enumeration date
09/02/2010
Last updated
09/02/2010
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