Provider Demographics
NPI:1902591209
Name:OHIO DENTAL CLINIC
Entity Type:Organization
Organization Name:OHIO DENTAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-899-6600
Mailing Address - Street 1:6075 CLEVELAND AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-2242
Mailing Address - Country:US
Mailing Address - Phone:614-899-6600
Mailing Address - Fax:614-899-9094
Practice Address - Street 1:6075 CLEVELAND AVE STE 107
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-2242
Practice Address - Country:US
Practice Address - Phone:614-899-6600
Practice Address - Fax:614-899-9094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-11
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty