Mid Ohio Dental Associates
Dentist in Columbus, OH. Organization (NPI-2).
NPI number1619086717
StatusActive
Last updated in NPPESSep 2, 2025
Details
- NPI
- 1619086717
- Entity type
- Organization (NPI-2)
- Legal business name
- Mid Ohio Dental Associates
- Organization subpart
- No
- Enumeration date
- Aug 30, 2006
- Last updated
- Sep 2, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 30016727 | OH | Yes |
Other names
- Mid Ohio Dental Associates (Doing Business As)
Practice location
3079 W. Broad Ste Suite 7Columbus, OH 43204
Phone 614-279-9204 · Fax 614-279-9208
Mailing address
3079 W. Broad Ste Suite 7Columbus, OH 43204
Phone 614-279-9204 · Fax 614-279-9208
Authorized official
Jack Daniel Castilla
Dentist
6142799204
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