Organization
NEWARK PERIODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON C STONER DDS (MEMBER)
(614) 889-8222
Entity
Organization
Contact information
Practice address
843 N 21ST ST STE 102A, NEWARK, OH 43055-7274
(740) 366-7207
Mailing address
5152 BLAZER PKWY, DUBLIN, OH 43017-7315
(614) 889-8222
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30020951
LICENSE
OH
Enumeration date
07/08/2019
Last updated
07/08/2019
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