Organization
K. PETE CZARUK, D.D.S., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELLA COLLINS CODA, CP (DENTAL ASSITANT)
(614) 459-3740
Entity
Organization
Contact information
Practice address
2066 W HENDERSON RD, COLUMBUS, OH 43220-2452
(614) 459-3740
(614) 586-0065
Mailing address
2066 W HENDERSON RD, COLUMBUS, OH 43220-2452
(614) 459-3740
(614) 586-0065
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30015642
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0368785
—
OH
Enumeration date
02/24/2010
Last updated
02/24/2010
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