Basic Information
| Provider Information | |||||||||
| NPI: | 1508471392 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MUSIAL-GILL PROPERTIES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 982 GALLOWAY RD | ||||||||
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| City: | GALLOWAY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 431198293 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6148701333 | ||||||||
| FaxNumber: | 6148700333 | ||||||||
| Practice Location | |||||||||
| Address1: | 3646 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | WHITEHALL | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432132913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142314800 | ||||||||
| FaxNumber: | 6142314801 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/09/2020 | ||||||||
| LastUpdateDate: | 09/10/2020 | ||||||||
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| AuthorizedOfficialLastName: | DOTSON | ||||||||
| AuthorizedOfficialFirstName: | SHERRY | ||||||||
| AuthorizedOfficialMiddleName: | ELIZABETH | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 6148701333 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 09/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QD0000X | Y | Ambulatory Health Care Facilities | Clinic/Center | Dental |
No ID Information.