Modern Dental Professionals-Lee,inc

NPI #1669656104 in Piqua, Ohio

Provider Information

NPI Number: 1669656104
Entity Type: Organization
Organization Name: Modern Dental Professionals-Lee,inc
Subpart: Yes (part of a larger organization)
Parent Organization: MODERN DENTAL PROFESSIONALS-LEE,INC
Primary Specialty: Dentist - General Practice
Enumeration Date: Dec 19, 2007
Last Updated: Dec 19, 2007

Practice Location

Address: 987 E ASH ST
Address 2: STE 154
City: Piqua
State: Ohio
ZIP Code: 45356-4133
Phone: (937) 778-0150

Authorized Official

Name: RHONDA KELLER
Title: DISTRICT MANAGER
Phone: (937) 278-7956

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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