| NPI | 1710575360 |
|---|---|
| Former Legal Business Name | BOUNDLESS HEALTH, INC. |
| Entity Type | Organization |
| Authorized Contact | LAURIE HICKMAN Contracting & Credentialing Manager 614-844-3800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| 1223P0221X Dentist, Pediatric Dentistry | |
| Enumeration Date | 2021-01-08 |
| Last Update Date | 2024-09-24 |