Ohio Dental Professionals, Delisle, P.c.

NPI #1780350991 in Fairfield, Ohio

Provider Information

NPI Number: 1780350991
Entity Type: Organization
Organization Name: Ohio Dental Professionals, Delisle, P.c.
Subpart: Yes (part of a larger organization)
Parent Organization: OHIO DENTAL PROFESSIONALS, DELISLE, P.C.
Primary Specialty: Dentist - General Practice
Enumeration Date: Aug 18, 2021
Last Updated: Aug 18, 2021

Practice Location

Address: 3174 MACK RD
City: Fairfield
State: Ohio
ZIP Code: 45014-5370
Phone: (513) 746-8228

Authorized Official

Name: TABATHA LEMKE
Title: CREDENTIALING COORDINATOR
Phone: (217) 540-6078

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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