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9420 Lebanon Pike Centerville OH 45458-3860 | |
(937) 433-8900 | |
(937) 433-8905 |
Full Name | |
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Speciality | Dentist |
Location | 9420 Lebanon Pike, Centerville, Ohio |
Authorized Official Name and Position | John Clarke Sanders (OWNER) |
Authorized Official Contact | 6148643196 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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9420 Lebanon Pike Centerville OH 45458-3860 Ph: (937) 433-8900 | 9420 Lebanon Pike Centerville OH 45458-3860 Ph: (937) 433-8900 |
NPI Number | 1659504884 |
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Provider Enumeration Date | 09/04/2009 |
Last Update Date | 09/04/2009 |
Identifier | Type | State | Issuer |
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1659504884 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | 17563 (Ohio) | Primary |
Professional Dental Alliance Of Centerville, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9420 Dayton Lebanon Pike, Centerville, OH 45458 Phone: 937-433-8900 | |