Organization
SOUTH VIENNA FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRFAN KHAN DDS (OWNER)
(937) 568-3302
Entity
Organization
Contact information
Practice address
8490 E NATIONAL RD, SOUTH VIENNA, OH 45369-9707
(937) 568-3302
(937) 568-3304
Mailing address
8490 E NATIONAL RD, PO BOX 215, SOUTH VIENNA, OH 45369-9707
(937) 568-3302
(937) 568-3304
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30-022887
OH
Other
Enumeration date
12/19/2014
Last updated
12/19/2014
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