Organization
EAST COLUMBUS PERIODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON C STONER DDS (MEMBER)
(614) 889-8222
Entity
Organization
Contact information
Practice address
5180 E MAIN ST, COLUMBUS, OH 43213-2436
(614) 864-2561
Mailing address
5152 BLAZER PKWY STE 100, DUBLIN, OH 43017-7323
(614) 889-8222
(614) 889-6067
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30020951
LICENSE
OH
Enumeration date
08/19/2020
Last updated
08/19/2020
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