Organization
MICHAEL S TILSON, DDS MS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL S TILSON DDS MS (PRESIDENT)
(614) 863-4664
Entity
Organization
Contact information
Practice address
1545 BRICE RD, REYNOLDSBURG, OH 43068
(614) 863-4664
(614) 751-1792
Mailing address
1545 BRICE RD, REYNOLDSBURG, OH 43068
(614) 863-4664
(614) 751-1792
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30020344
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013191402
DENTIST
OH
01
—
1962449298
DENTAL
OH
Enumeration date
11/10/2006
Last updated
06/02/2014
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