Provider Demographics
NPI:1710734801
Name:OSSA ORTHODONTICS LLC
Entity type:Organization
Organization Name:OSSA ORTHODONTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSSA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MA
Authorized Official - Phone:740-629-2510
Mailing Address - Street 1:301 CHAMBERLAIN DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-1004
Mailing Address - Country:US
Mailing Address - Phone:740-629-2510
Mailing Address - Fax:
Practice Address - Street 1:44515 MARIETTA RD
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:OH
Practice Address - Zip Code:43724
Practice Address - Country:US
Practice Address - Phone:740-629-2510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty