Organization
KEEP SMILING DENTAL GROUP DRS. RODDY & PALM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUE RADER (BUSINESS MANAGER)
(937) 426-5340
Entity
Organization
Contact information
Practice address
4090 INDIAN RIPPLE RD STE 101, BEAVERCREEK, OH 45440-3292
(937) 426-5340
Mailing address
4090 INDIAN RIPPLE RD STE 101, BEAVERCREEK, OH 45440-3292
(937) 426-5340
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013089770
NPPES
—
01
—
1376034488
NPPES
—
01
—
30.019043
OHIO STATE DENTAL BOARD
OH
01
—
30.025388
OHIO STATE DENTAL BOARD
OH
Enumeration date
03/16/2021
Last updated
03/16/2021
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