Provider Demographics
NPI:1871029488
Name:BRICE DENTAL, LLC
Entity Type:Organization
Organization Name:BRICE DENTAL, LLC
Other - Org Name:BRICE DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:E
Authorized Official - Last Name:CONROY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-565-3294
Mailing Address - Street 1:43 E NORTH ST
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-4027
Mailing Address - Country:US
Mailing Address - Phone:614-866-5966
Mailing Address - Fax:614-866-6029
Practice Address - Street 1:1600 BRICE RD
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-2795
Practice Address - Country:US
Practice Address - Phone:614-565-3294
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH199501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty