Organization
BETHESDA DENTAL CENTER,MIRFENDERESKI, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEAN MIRFENDERESKI DDS (OWNER)
(740) 454-9961
Entity
Organization
Contact information
Practice address
830 BETHESDA DR, ZANESVILLE, OH 43701-1895
(740) 454-9961
(740) 454-1670
Mailing address
830 BETHESDA DR, ZANESVILLE, OH 43701-1895
(740) 454-9961
(740) 454-1670
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30-021794
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0199968
—
OH
05
—
2657638
—
OH
Enumeration date
06/05/2012
Last updated
06/05/2012
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