Provider Demographics
NPI:1790919785
Name:PRICE, MINDY ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MINDY
Middle Name:ANN
Last Name:PRICE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 LAZELLE RD STE D
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-8605
Mailing Address - Country:US
Mailing Address - Phone:614-888-3212
Mailing Address - Fax:
Practice Address - Street 1:117 LAZELLE RD STE D
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-8605
Practice Address - Country:US
Practice Address - Phone:614-888-3212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-06
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30023064122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist