Organization
MODERN DENTAL PROFESSIONALS-LEE,INC
Active
Parent organization
MODERN DENTAL PROFESSIONALS-LEE,INC
Other names
BRIGHT NOW 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
36 FIESTA LN, MIAMISBURG, OH 45342-5301
(937) 298-7800
Mailing address
36 FIESTA LN, MIAMISBURG, OH 45342-5301
(937) 298-7800
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30.019758
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2203832
—
OH
Enumeration date
12/19/2007
Last updated
04/15/2011
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