| Sdsdds, LLC | |
|
1850 Grand Portage Trl Xenia OH 45385-9593 | |
| (937) 369-3069 | |
| (937) 431-1268 |
| Full Name | Sdsdds, LLC |
|---|---|
| Speciality | Dentist |
| Location | 1850 Grand Portage Trl, Xenia, Ohio |
| Authorized Official Name and Position | Steve D Shufflebarger (SINGLE MEMBER) |
| Authorized Official Contact | 9373693069 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sdsdds, LLC 1850 Grand Portage Trl Xenia OH 45385-9593 Ph: (937) 369-3069 | Sdsdds, LLC 1850 Grand Portage Trl Xenia OH 45385-9593 Ph: (937) 369-3069 |
| NPI Number | 1326215005 |
|---|---|
| Provider Enumeration Date | 05/13/2008 |
| Last Update Date | 05/13/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326215005 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 30021080 (Ohio) | Primary |
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Mark J. Buchwalder D.D.S., L.L.C. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1237 N Monroe Dr, Suite 103, Xenia, OH 45385 Phone: 937-376-2441 |
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