Provider Demographics
NPI:1386481810
Name:EAST COLUMBUS FAMILY DENTAL CARE LLC
Entity type:Organization
Organization Name:EAST COLUMBUS FAMILY DENTAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:RHOADS
Authorized Official - Last Name:GLYNN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-805-2445
Mailing Address - Street 1:1966 WESTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-1136
Mailing Address - Country:US
Mailing Address - Phone:614-805-2445
Mailing Address - Fax:
Practice Address - Street 1:1561 BRICE RD
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-2701
Practice Address - Country:US
Practice Address - Phone:614-864-4618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty