Provider Demographics
NPI:1275208498
Name:M ALEXANDRUNAS D HUDOBA DENTAL 1 INC
Entity Type:Organization
Organization Name:M ALEXANDRUNAS D HUDOBA DENTAL 1 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:R
Authorized Official - Last Name:ALEXANDRUNAS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:740-587-4891
Mailing Address - Street 1:13 LISBON ST
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-1415
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13 LISBON ST
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-1415
Practice Address - Country:US
Practice Address - Phone:330-533-5666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:M ALEXANDRUNAS D HUDOBA DENTAL 1 INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental