Provider Demographics
NPI:1134215353
Name:GROVE CITY FAMILY DENTISTRY INC
Entity type:Organization
Organization Name:GROVE CITY FAMILY DENTISTRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:OILER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-875-2153
Mailing Address - Street 1:3031 COLUMBUS STREET
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123
Mailing Address - Country:US
Mailing Address - Phone:614-875-2153
Mailing Address - Fax:614-871-7471
Practice Address - Street 1:3031 COLUMBUS STREET
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123
Practice Address - Country:US
Practice Address - Phone:614-875-2153
Practice Address - Fax:614-871-7471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30019188122300000X
OH30021400122300000X
30020068122300000X
OH30020557122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty