Organization
AFINIA DENTAL - KILLGORE FIELDS ERTEL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW MICHAEL KILLGORE DMD (OWNER/PRESIDENT)
(513) 777-9117
Entity
Organization
Contact information
Practice address
9415 FIELDS ERTEL RD, CINCINNATI, OH 45249-8212
(513) 777-9117
(513) 843-7830
Mailing address
792 EASTGATE SOUTH DR STE 250, CINCINNATI, OH 45245-1563
(513) 777-9117
(513) 843-7830
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30022880
OH
Other
Enumeration date
06/13/2012
Last updated
06/13/2012
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