# FRESH DENTAL

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

## Provider details

- **NPI number:** 1265039465
- **Authorized official:** DR. EJAZ AHMED LAKHANI DDS (DENTIST)
- **Authorized official phone:** (513) 697-1211

## Contact information

- **Practice address:** 11907 MONTGOMERY RD, CINCINNATI, OH 45249-1794
- **Practice address phone:** (513) 697-1211
- **Practice address fax:** (513) 697-1214
- **Mailing address:** 11907 MONTGOMERY RD, CINCINNATI, OH 45249-1794
- **Mailing address phone:** (513) 697-1211

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/01/2020
- **Last updated:** 10/01/2020