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Organization

OHIO DENTAL PROFESSIONALS, DELISLE, PC

Active
Parent organization
OHIO DENTAL PROFESSIONALS, DELISLE, PC
Other names
East Broad Family Dentistry
Organization subpart
Yes

Provider details

NPI number
Legal business name
OHIO DENTAL PROFESSIONALS, DELISLE, PC
Authorized official
KENDRA WALKER (CREDENTIALING COORDINATOR)
(217) 540-8312
Entity
Organization

Contact information

Practice address
8086 E BROAD ST, REYNOLDSBURG, OH 43068
(614) 328-9661
Mailing address
8086 E BROAD ST, REYNOLDSBURG, OH 43068-8024
(614) 328-9661

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30024311
OH

Other

Enumeration date
03/02/2015
Last updated
03/04/2015
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