Provider Demographics
NPI:1932461837
Name:RUNION DENTAL GROUP,LLC
Entity Type:Organization
Organization Name:RUNION DENTAL GROUP,LLC
Other - Org Name:BEECHER CROSSING DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:J
Authorized Official - Last Name:NORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-775-1300
Mailing Address - Street 1:1110 BEECHER XING N
Mailing Address - Street 2:SUITE A
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-4564
Mailing Address - Country:US
Mailing Address - Phone:614-775-1300
Mailing Address - Fax:614-775-9355
Practice Address - Street 1:1110 BEECHER XING N
Practice Address - Street 2:SUITE A
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-4564
Practice Address - Country:US
Practice Address - Phone:614-775-1300
Practice Address - Fax:614-775-9355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0232801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty