| NPI | 1952918443 |
|---|---|
| Doing Business As | NORTHSIDE DENTAL |
| Entity Type | Organization |
| Authorized Contact | RYAN MATHEW DURNER Owner 614-204-6818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2021-05-07 |