Organization
MODERN DENTAL PROFESSIONALS-LEE,INC
Active
Parent organization
MODERN DENTAL PROFESSIONALS-LEE,INC
Other names
MONARCH DENTAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
MODERN DENTAL PROFESSIONALS-LEE,INC
Authorized official
RHONDA KELLER (DISTRICT MANAGER)
(937) 278-7956
Entity
Organization
Contact information
Practice address
987 E ASH ST, STE 154, PIQUA, OH 45356-4133
(937) 778-0150
Mailing address
987 E ASH ST, STE 154, PIQUA, OH 45356-4133
(937) 778-0150
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30.019758
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2181428
—
OH
Enumeration date
12/19/2007
Last updated
12/19/2007
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