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Organization

OHIO DENTAL PROFESSIONALS, DELISLE, P.C.

Active
Parent organization
OHIO DENTAL PROFESSIONALS, DELISLE, P.C.
Other names
Blank Dental Group - Springfield
Organization subpart
Yes

Provider details

NPI number
Legal business name
OHIO DENTAL PROFESSIONALS, DELISLE, P.C.
Authorized official
HILLARY THULL (CREDENTIALING COORDINATOR)
(217) 540-8946
Entity
Organization

Contact information

Practice address
200 N FOUNTAIN AVE, SPRINGFIELD, OH 45504-2535
(937) 399-9381
Mailing address
200 N FOUNTAIN AVE, SPRINGFIELD, OH 45504-2535

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
02/21/2023
Last updated
02/21/2023
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