| Magnolia Dental | |
|
11 Medical Dr Chillicothe OH 45601-8603 | |
| (740) 775-8050 | |
| (740) 775-8053 |
| Full Name | Magnolia Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11 Medical Dr, Chillicothe, Ohio |
| Authorized Official Name and Position | Bryan D Basom (OWNER/DENTIST) |
| Authorized Official Contact | 7407758050 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Dental 11 Medical Dr Chillicothe OH 45601-8603 Ph: (740) 775-8050 | Magnolia Dental 11 Medical Dr Chillicothe OH 45601-8603 Ph: (740) 775-8050 |
| NPI Number | 1104134881 |
|---|---|
| Provider Enumeration Date | 09/16/2010 |
| Last Update Date | 09/16/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104134881 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 30022613 (Ohio) | Primary |
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