Individual
DR. ANDREW ROBERT MULLENDORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D.
Contact information
Practice address
6555 E BROAD ST, COLUMBUS, OH 43213-1509
(614) 427-0400
Mailing address
6555 E BROAD ST, COLUMBUS, OH 43213-1509
(614) 427-0400
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2004012411
MO
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
30-023253
OH
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
096558
OH
Other
Enumeration date
06/15/2006
Last updated
12/13/2016
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