Buckeye Oral & Maxillofacial Surgey

NPI 1073855193 - Clinic/Center - 261QS0112X

NPI Details
NPI 1073855193
Enumeration Date 03/27/2013
Last Updated 03/27/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name JACK B JACK
Position OWNER
Phone (614) 794-9700
Fax
Practice Location
110 POLARIS PARKWAY
SUITE 110
WESTERVILLE OH, 43082-0000, US
Phone (614) 794-9700
Fax
Business Location
PO BOX 2443
WESTERVILLE OH, 43086-2443, US
Phone (614) 794-9700
Fax
Toxanomy
Taxonomy Code 261QS0112X
License State Ohio
License Number 30022456
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According to our database, Buckeye Oral & Maxillofacial Surgey NPI is 1073855193, taxonomy code is 261QS0112X and license number is 30022456, license state is located at Ohio. Buckeye Oral & Maxillofacial Surgey physically located at 110 Polaris Parkway, Westerville OH, 43082-0000. NPI Number 1033115704 has the healthcare provider type.

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1073855193 NPI number is provided on an as is basis without warranty of any kind. 1073855193 is maintained by the National Plan & Provider Enumeration System. The contents of Buckeye Oral & Maxillofacial Surgey are for informational purposes only.