Provider Demographics
NPI:1891046678
Name:BEXLEY JAW & FACIAL SURGERY, INC
Entity Type:Organization
Organization Name:BEXLEY JAW & FACIAL SURGERY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:R
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-751-7500
Mailing Address - Street 1:1575 CROSS CREEKS BLVD
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-8237
Mailing Address - Country:US
Mailing Address - Phone:614-751-7500
Mailing Address - Fax:614-322-7900
Practice Address - Street 1:3366 E BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1008
Practice Address - Country:US
Practice Address - Phone:614-236-8008
Practice Address - Fax:614-322-7900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-20
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty