| Louis J Altomare & Bryan J Simone | |
|
4104 Broadway Grove City OH 43123-3065 | |
| (614) 875-3141 | |
| Not Available |
| Full Name | Louis J Altomare & Bryan J Simone |
|---|---|
| Speciality | Dentist |
| Location | 4104 Broadway, Grove City, Ohio |
| Authorized Official Name and Position | Bryan J Simone (PARTNER) |
| Authorized Official Contact | 6148753141 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Louis J Altomare & Bryan J Simone 4104 Broadway Grove City OH 43123 Ph: (614) 875-3141 | Louis J Altomare & Bryan J Simone 4104 Broadway Grove City OH 43123-3065 Ph: (614) 875-3141 |
| NPI Number | 1184757858 |
|---|---|
| Provider Enumeration Date | 03/13/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184757858 | NPI | - | NPPES |
| 0893645 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12620 (Ohio) | Secondary |
| 122300000X | Dentist | 19692 (Ohio) | Primary |
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