Provider Demographics
NPI:1164019998
Name:BRICELAND-KOLP & WILLMANN DENTAL LLC
Entity type:Organization
Organization Name:BRICELAND-KOLP & WILLMANN DENTAL LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRICELAND-KOLP
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-850-0446
Mailing Address - Street 1:3734 RIDGE MILL DR
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-7450
Mailing Address - Country:US
Mailing Address - Phone:614-850-0446
Mailing Address - Fax:614-850-0446
Practice Address - Street 1:3734 RIDGE MILL DR
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-7450
Practice Address - Country:US
Practice Address - Phone:614-850-0446
Practice Address - Fax:614-850-0446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-28
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty