Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 30.026074 | OH |
NPI | 1033568670 |
---|---|
Provider Name | Alyssa Loparich |
First Address | Columbus, OH 43213-1509 |
Second Address | Columbus, OH 43213-1509 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2016 |
Last Update Date | 03/12/2020 |