Provider Demographics
NPI:1306445572
Name:BRICE DENTAL GROUP LLC
Entity type:Organization
Organization Name:BRICE DENTAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:E
Authorized Official - Last Name:CONROY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-565-3294
Mailing Address - Street 1:43 E NORTH ST
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-4027
Mailing Address - Country:US
Mailing Address - Phone:614-565-3294
Mailing Address - Fax:
Practice Address - Street 1:1600 BRICE RD
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-2795
Practice Address - Country:US
Practice Address - Phone:614-565-3294
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental