| NPI | 1477216901 |
|---|---|
| Doing Business As | COLVIN AVENUE DENTAL |
| Entity Type | Organization |
| Authorized Contact | GREGORY LEWIS Member 614-563-0271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-10-21 |
| Last Update Date | 2021-10-21 |