Individual
LILY ETEMAD ETEMAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 CROSS CREEKS BLVD, PICKERINGTON, OH 43147-8189
(614) 292-9100
Mailing address
808 YARD ST APT 329, COLUMBUS, OH 43212-3909
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
RES.004221
OH
Other
Enumeration date
10/10/2020
Last updated
10/10/2020
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