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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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