Provider Demographics
NPI:1427184894
Name:DENTAL ASSOCIATES LM SHELL DDS & WA RECORDS DDS INC
Entity Type:Organization
Organization Name:DENTAL ASSOCIATES LM SHELL DDS & WA RECORDS DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:RECORDS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-235-3444
Mailing Address - Street 1:2862 E MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209
Mailing Address - Country:US
Mailing Address - Phone:614-235-3444
Mailing Address - Fax:614-235-3495
Practice Address - Street 1:2862 E MAIN STREET
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209
Practice Address - Country:US
Practice Address - Phone:614-235-3444
Practice Address - Fax:614-235-3495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty