Provider Demographics
NPI:1588255566
Name:TALUS AFFILIATES INC.
Entity type:Organization
Organization Name:TALUS AFFILIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:JOLLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-915-5780
Mailing Address - Street 1:125 TOWNE CENTRE BLVD STE 510
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-5619
Mailing Address - Country:US
Mailing Address - Phone:412-348-8676
Mailing Address - Fax:
Practice Address - Street 1:125 TOWNE CENTRE BLVD STE 510
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-5619
Practice Address - Country:US
Practice Address - Phone:412-348-8676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TALUS AFFILIATES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty