Organization
OLLOM DDS TIPP CITY LLC
Active
Parent organization
OLLOM ENTERPRISES LLC
Other names
Pure Smiles Tipp City
Organization subpart
Yes
Provider details
NPI number
Legal business name
OLLOM ENTERPRISES LLC
Authorized official
MRS. BOBBE CAMPBELL (DIRECTOR OF OPERATIONS)
(937) 667-2417
Entity
Organization
Contact information
Practice address
110 S TIPPECANOE DR, TIPP CITY, OH 45371-3104
(937) 667-2417
Mailing address
2115 ALLENTOWN RD, LIMA, OH 45805-1749
(419) 228-4036
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366754723
NPI
—
Enumeration date
05/06/2019
Last updated
10/20/2021
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