| Bryan J. Simone D.d.s.,llc | |
|
4104 Broadway Grove City OH 43123-3065 | |
| (614) 875-3141 | |
| (614) 875-8812 |
| Full Name | Bryan J. Simone D.d.s.,llc |
|---|---|
| Speciality | Dentist |
| Location | 4104 Broadway, Grove City, Ohio |
| Authorized Official Name and Position | Bryan J. Simone (OWNER) |
| Authorized Official Contact | 6148753141 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bryan J. Simone D.d.s.,llc 4104 Broadway Grove City OH 43123-3065 Ph: (614) 875-3141 | Bryan J. Simone D.d.s.,llc 4104 Broadway Grove City OH 43123-3065 Ph: (614) 875-3141 |
| NPI Number | 1831366707 |
|---|---|
| Provider Enumeration Date | 05/10/2008 |
| Last Update Date | 05/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831366707 | NPI | - | NPPES |
| 2798012 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 30-19692 (Ohio) | Primary |
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