Individual
PETR ALEXANDER VAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6558 GLENWAY AVE, CINCINNATI, OH 45211-4410
(513) 613-3232
Mailing address
5310 WAKEFIELD PL, NORWOOD, OH 45212-1737
(937) 245-0390
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
30026130
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2020
Last updated
10/01/2024
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