Organization
CINCINNATI ORAL & MAXILLOFACIAL SURGERY ASSOC., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES P CASSIDY DDS (PRESIDENT)
(513) 624-0055
Entity
Organization
Contact information
Practice address
7803 5 MILE RD, CINCINNATI, OH 45230-2347
(513) 624-0055
Mailing address
7141 MIAMI AVE, 202, CINCINNATI, OH 45243-2616
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
30017898
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CI9928971
MEDICARE
OH
01
—
U33502
UPIN
OH
Enumeration date
08/22/2007
Last updated
08/22/2007
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