Organization
COLUMBUS SMILES YOUTH DENTISTRY LLC MICHAEL CRITES, DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENELL STUMP (MANAGER, LICENSING & CREDENTIALING)
(615) 750-0343
Entity
Organization
Contact information
Practice address
4655 MORSE CENTRE RD, COLUMBUS, OH 43229-6601
(614) 470-9840
(614) 470-9841
Mailing address
16 ARCADE UNIT 198747, NASHVILLE, TN 37219-1994
(615) 750-0343
(615) 986-1705
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1777426
UNITED CONCORDIA
OH
05
—
2528205
—
OH
Enumeration date
11/21/2006
Last updated
07/09/2014
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