Provider Demographics
NPI:1467972075
Name:COURT HOUSE DENTAL, MICHAEL PAPPAS, DDS, LLC
Entity Type:Organization
Organization Name:COURT HOUSE DENTAL, MICHAEL PAPPAS, DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPPAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:440-341-9233
Mailing Address - Street 1:903 S FRONT ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43206-2520
Mailing Address - Country:US
Mailing Address - Phone:440-341-9233
Mailing Address - Fax:
Practice Address - Street 1:1387 LEESBURG AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON COURT HOUSE
Practice Address - State:OH
Practice Address - Zip Code:43160-8655
Practice Address - Country:US
Practice Address - Phone:440-341-9233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-24
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental