| Modern Dental Professionals-lee,inc | |
|
36 Fiesta Ln Miamisburg OH 45342-5301 | |
| (937) 298-7800 | |
| Not Available |
| Full Name | Modern Dental Professionals-lee,inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 36 Fiesta Ln, Miamisburg, Ohio |
| Authorized Official Name and Position | Rhonda Keller (DISTRICT MANAGER) |
| Authorized Official Contact | 9372787956 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Dental Professionals-lee,inc 36 Fiesta Ln Miamisburg OH 45342-5301 Ph: (937) 298-7800 | Modern Dental Professionals-lee,inc 36 Fiesta Ln Miamisburg OH 45342-5301 Ph: (937) 298-7800 |
| NPI Number | 1750565297 |
|---|---|
| Provider Enumeration Date | 12/19/2007 |
| Last Update Date | 04/15/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750565297 | NPI | - | NPPES |
| 2203832 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 30.019758 (Ohio) | Primary |
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