614 Dental Group
Dentist, General Practice in Columbus, OH. Organization (NPI-2).
NPI number1285445288
StatusActive
Last updated in NPPESJan 17, 2025
Details
- NPI
- 1285445288
- Entity type
- Organization (NPI-2)
- Legal business name
- 614 Dental Group
- Organization subpart
- No
- Enumeration date
- Jan 17, 2025
- Certification date
- Jan 17, 2025
- Last updated
- Jan 17, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
| 261QD0000X | Clinic/Center, Dental | – | – |
Practice location
81 S 4th St Ste 205Columbus, OH 43215-4308
Phone 614-588-8200
Mailing address
2028 Floral AveColumbus, OH 43223-1106
Phone 614-632-3150
Authorized official
Tara Herman
Owner / Office Manager
6146323150
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