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Organization

GEM CITY DENTAL GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATHY LOWELL (ADMINISTRATIVE ASSISTANT)
(937) 938-5529
Entity
Organization

Contact information

Practice address
627 S EDWIN C. MOSES BLVD., SUITE 2A, DAYTON, OH 45417-3461
(937) 938-5529
(937) 938-6754
Mailing address
627 S EDWIN C. MOSES BLVD., SUITE 2A, DAYTON, OH 45417-3461
(937) 938-5529
(937) 938-6754

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
23113
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2991722
OH
Enumeration date
03/20/2013
Last updated
03/20/2013
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