Provider Demographics
NPI:1578008439
Name:EASTPOINT DENTAL
Entity Type:Organization
Organization Name:EASTPOINT DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-755-2275
Mailing Address - Street 1:7334 E BROAD ST STE A
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-9239
Mailing Address - Country:US
Mailing Address - Phone:614-755-2275
Mailing Address - Fax:614-759-4699
Practice Address - Street 1:7334 E BROAD ST STE A
Practice Address - Street 2:
Practice Address - City:BLACKLICK
Practice Address - State:OH
Practice Address - Zip Code:43004-9239
Practice Address - Country:US
Practice Address - Phone:614-755-2275
Practice Address - Fax:614-759-4699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-03
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH161421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty