Organization
PETR VAUGHAN, DDS, LLC
Active
Other names
Westside Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
PETR ALEXANDER VAUGHAN DDS (OWNER/PRESIDENT)
(937) 245-0390
Entity
Organization
Contact information
Practice address
6558 GLENWAY AVE, CINCINNATI, OH 45211-4410
(937) 245-0390
Mailing address
5310 WAKEFIELD PL, NORWOOD, OH 45212-1737
(937) 245-0390
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
09/30/2022
Last updated
09/30/2022
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