Provider Demographics
NPI:1790302081
Name:TOPS ORTHODONTICS, L.L.C.
Entity Type:Organization
Organization Name:TOPS ORTHODONTICS, L.L.C.
Other - Org Name:AVANTGARDE ORTHODONTICS
Other - Org Type:Other Name
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAHYE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MSD
Authorized Official - Phone:740-368-0886
Mailing Address - Street 1:163 N SANDUSKY ST LOWR L-100
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-1785
Mailing Address - Country:US
Mailing Address - Phone:740-363-0886
Mailing Address - Fax:
Practice Address - Street 1:163 N SANDUSKY ST LOWR L-100
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-1785
Practice Address - Country:US
Practice Address - Phone:740-363-0886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-02
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty