Individual
KETKI B DESAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5212 WEST BROAD STREET, COLUMBUS, OH 43228
(614) 878-3636
(614) 878-6224
Mailing address
5212 WEST BROAD STREET, COLUMBUS, OH 43228
(614) 878-3636
(614) 878-6224
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18873
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0765766
—
OH
Enumeration date
10/03/2006
Last updated
04/15/2013
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