Provider Demographics
NPI:1609421684
Name:COLUMBUS ENDODONTIC SPECIALISTS
Entity Type:Organization
Organization Name:COLUMBUS ENDODONTIC SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:K
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-577-1100
Mailing Address - Street 1:7334 E BROAD ST STE C
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:614-577-1100
Mailing Address - Fax:614-577-1348
Practice Address - Street 1:7334 E BROAD ST STE C
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:614-577-1100
Practice Address - Fax:614-577-1348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty