Provider Demographics
NPI:1871982819
Name:TERRENCE S POOLE DDS LLC
Entity type:Organization
Organization Name:TERRENCE S POOLE DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST / OWENER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRENCE
Authorized Official - Middle Name:S
Authorized Official - Last Name:POOLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:513-961-1991
Mailing Address - Street 1:PO BOX 12112
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-0112
Mailing Address - Country:US
Mailing Address - Phone:513-961-1991
Mailing Address - Fax:513-961-1993
Practice Address - Street 1:8250 KENWOOD CROSSING WAY
Practice Address - Street 2:SUITE 220
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-3668
Practice Address - Country:US
Practice Address - Phone:513-961-1991
Practice Address - Fax:513-961-1993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-14
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty