| Petr Vaughan, Dds, Llc | |
|
6558 Glenway Ave Cincinnati OH 45211-4410 | |
| (937) 245-0390 | |
| Not Available |
| Full Name | Petr Vaughan, Dds, Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 6558 Glenway Ave, Cincinnati, Ohio |
| Authorized Official Name and Position | Petr Alexander Vaughan (OWNER/PRESIDENT) |
| Authorized Official Contact | 9372450390 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Petr Vaughan, Dds, Llc 5310 Wakefield Pl Norwood OH 45212-1737 Ph: (937) 245-0390 | Petr Vaughan, Dds, Llc 6558 Glenway Ave Cincinnati OH 45211-4410 Ph: (937) 245-0390 |
| NPI Number | 1326762550 |
|---|---|
| Provider Enumeration Date | 09/30/2022 |
| Last Update Date | 09/30/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326762550 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
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