Organization
DENTAL CLINIC COLLEGE OF DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY FISCHBACH DDS (ASSISTANT DEAN)
(614) 292-0050
Entity
Organization
Contact information
Practice address
305 W 12TH AVE, ROOM 1130 POSTLE HALL, COLUMBUS, OH 43210-1267
(614) 292-6983
(614) 688-3671
Mailing address
305 W 12TH AVE, ROOM 1130 POSTLE HALL, COLUMBUS, OH 43210-1267
(614) 292-6983
(614) 688-3671
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0098193
—
OH
01
—
2412535+0098193
BCMH GENERAL COLLEGE
OH
01
—
2414024+0098193
BCMH ORTHODONTICS COLLEGE
OH
01
—
316025986028
CARESOURCE
OH
01
—
54350690400
BUREAU OF WORKMAN'S COMP
OH
01
—
88300
DELTA DENTAL
OH
Enumeration date
08/21/2006
Last updated
09/17/2013
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