Individual
TRISTA MULLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11660 UPPER GILCHRIST RD, MOUNT VERNON, OH 43050-9084
(740) 399-2200
Mailing address
338 E MAPLE ST, GRANVILLE, OH 43023-1415
(812) 267-6311
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019.031815
IL
122300000X
Dentist
12013038A
IN
122300000X
Dentist
Primary
30.026333
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0423186
—
OH
05
—
300019367
—
IN
Enumeration date
08/14/2018
Last updated
03/23/2021
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