Provider Demographics
NPI:1376862243
Name:JEFF KOVER D.D.S. AND ASSOC, LLC
Entity Type:Organization
Organization Name:JEFF KOVER D.D.S. AND ASSOC, LLC
Other - Org Name:KOVER DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:KOVER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-428-0487
Mailing Address - Street 1:1375 CHERRY WAY DR
Mailing Address - Street 2:#210
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-8700
Mailing Address - Country:US
Mailing Address - Phone:614-428-0487
Mailing Address - Fax:614-428-0650
Practice Address - Street 1:455 INDUSTRIAL MILE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-2482
Practice Address - Country:US
Practice Address - Phone:614-428-0487
Practice Address - Fax:614-428-0650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-18
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty