Provider Demographics
NPI:1063860062
Name:ELIZABETH L. OSTERDAY, D.D.S., L.L.C.
Entity type:Organization
Organization Name:ELIZABETH L. OSTERDAY, D.D.S., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:OSTERDAY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:513-231-9300
Mailing Address - Street 1:1149 FEHL LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-4349
Mailing Address - Country:US
Mailing Address - Phone:513-231-9300
Mailing Address - Fax:513-231-9346
Practice Address - Street 1:1149 FEHL LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-4349
Practice Address - Country:US
Practice Address - Phone:513-231-9300
Practice Address - Fax:513-231-9346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-921992305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service