| NPI | 1003641978 |
|---|---|
| Doing Business As | FOUNTAIN VALLEY SMILES |
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER WILLIAM ANDONIAN President 614-256-6636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2024-09-03 |
| Last Update Date | 2024-09-03 |