Provider Demographics
NPI:1801915004
Name:ASSOCIATED ORTHODONTICS INC.
Entity type:Organization
Organization Name:ASSOCIATED ORTHODONTICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:CONROY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:614-775-1000
Mailing Address - Street 1:153 W MAIN ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-9224
Mailing Address - Country:US
Mailing Address - Phone:614-775-1000
Mailing Address - Fax:614-855-8503
Practice Address - Street 1:153 W MAIN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054-9224
Practice Address - Country:US
Practice Address - Phone:614-775-1000
Practice Address - Fax:614-855-8503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH212271223X0400X
OH138591223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty