Individual
DR. NICHOLAS ROBERT DESANTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1240 CRESCENT HEIGHTS RD, MARION, OH 43302-6408
(740) 387-5196
Mailing address
1240 CRESCENT HEIGHTS RD, MARION, OH 43302-6408
(740) 387-5196
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30-016967
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0466768
—
OH
Enumeration date
09/12/2006
Last updated
04/03/2008
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