Organization
SYLVANIA ORTHODONTICS, INC.
Active
Organization
SYLVANIA ORTHODONTICS, INC.
Active
Other names
Drs. Simon, Haerian & Ludwig
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDRE H. HAERIAN DDS, MS, FRCD, PHD (PRESIDENT)
(419) 882-1017
Entity
Organization
Contact information
Practice address
6407 MONROE STREET, SYLVANIA, OH 43560
(419) 882-1017
(419) 882-7571
Mailing address
6407 MONROE STREET, SYLVANIA, OH 43560
(419) 882-1017
(419) 882-7571
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12970
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12970
PROVIDER LICENSE #
OH
Enumeration date
11/16/2005
Last updated
10/16/2012
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