Provider Demographics
NPI:1891877627
Name:JOSE, JUDY ROH (DDS, MDSC)
Entity Type:Individual
Prefix:DR
First Name:JUDY
Middle Name:ROH
Last Name:JOSE
Suffix:
Gender:F
Credentials:DDS, MDSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1375 CHERRY WAY DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-8700
Mailing Address - Country:US
Mailing Address - Phone:614-428-7320
Mailing Address - Fax:614-428-7322
Practice Address - Street 1:1375 CHERRY WAY DR
Practice Address - Street 2:SUITE 200
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-8700
Practice Address - Country:US
Practice Address - Phone:614-428-7320
Practice Address - Fax:614-428-7322
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH201381223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics