Individual
DR. SEAN MIRFENDERESKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
65 E STATE ST, COLUMBUS, OH 43215-4213
(614) 461-4600
(614) 621-6129
Mailing address
65 E STATE ST, COLUMBUS, OH 43215-4213
(614) 461-4600
(614) 621-6129
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30-021794
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2657638
—
OH
Enumeration date
11/08/2006
Last updated
07/08/2007
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