Organization
KEVIN D. OH, LLC
Active
Other names
Aspen Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LA DUC (PROVIDER RELATIONS)
(315) 454-6000
Entity
Organization
Contact information
Practice address
1430 HIGHWAY 20 W, MCDONOUGH, GA 30253-7305
(678) 537-6000
(770) 957-0937
Mailing address
PO BOX 3189, SYRACUSE, NY 13220-3189
(315) 454-6000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
01/11/2017
Last updated
01/11/2017
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