Provider Demographics
NPI:1336433960
Name:DRS. WOLT, LEWIS AND NIEDERHELMAN LLC
Entity Type:Organization
Organization Name:DRS. WOLT, LEWIS AND NIEDERHELMAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:NIEDERHELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-791-9991
Mailing Address - Street 1:4770 INDIANOLA AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-1862
Mailing Address - Country:US
Mailing Address - Phone:614-396-6850
Mailing Address - Fax:614-396-6852
Practice Address - Street 1:4770 INDIANOLA AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1862
Practice Address - Country:US
Practice Address - Phone:614-396-6850
Practice Address - Fax:614-396-6852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty