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
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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