# A REZA MIREMADI MD DDS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053597930
- **Authorized official:** CINDY LAYMASTER (FINANCIAL MANAGER)
- **Authorized official phone:** (937) 748-8814

## Contact information

- **Practice address:** 576 N MAIN ST, SPRINGBORO, OH 45066-9552
- **Practice address phone:** (937) 748-8814
- **Practice address fax:** (937) 748-8817
- **Mailing address:** 576 N MAIN ST, SPRINGBORO, OH 45066-9552
- **Mailing address phone:** (937) 748-8814
- **Mailing address fax:** (937) 748-8817

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | — |

## Other

- **Enumeration date:** 01/10/2008
- **Last updated:** 01/09/2014