Provider Demographics
NPI:1366987869
Name:DR. CHRISTOPHER M. WILL DDS., INC
Entity type:Organization
Organization Name:DR. CHRISTOPHER M. WILL DDS., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:M
Authorized Official - Last Name:WILL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-488-3313
Mailing Address - Street 1:1480 GRANDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-2862
Mailing Address - Country:US
Mailing Address - Phone:614-488-3313
Mailing Address - Fax:614-488-6395
Practice Address - Street 1:1480 GRANDVIEW AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-2862
Practice Address - Country:US
Practice Address - Phone:614-488-3313
Practice Address - Fax:614-488-6395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-20
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30021087122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty