Blue Ash Oral And Maxillofacial Surgery, Inc | |
4350 Malsbary Rd Suite 201 Cincinnati OH 45242-5621 | |
(513) 984-2100 | |
(513) 984-2155 |
Full Name | Blue Ash Oral And Maxillofacial Surgery, Inc |
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Speciality | Clinic/center - Dental |
Location | 4350 Malsbary Rd, Cincinnati, Ohio |
Authorized Official Name and Position | Randall David Stastny (OWNER) |
Authorized Official Contact | 5139842100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Blue Ash Oral And Maxillofacial Surgery, Inc 4350 Malsbary Rd Suite 201 Cincinnati OH 45242-5621 Ph: (513) 984-2100 | Blue Ash Oral And Maxillofacial Surgery, Inc 4350 Malsbary Rd Suite 201 Cincinnati OH 45242-5621 Ph: (513) 984-2100 |
NPI Number | 1588759609 |
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Provider Enumeration Date | 10/04/2006 |
Last Update Date | 03/04/2008 |
Identifier | Type | State | Issuer |
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1588759609 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | 30-1-8892 (Ohio) | Primary |
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