Provider Demographics
NPI:1275584468
Name:TAHANEY, SEAN ROBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:ROBERT
Last Name:TAHANEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 S LAPEER RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48371-5041
Mailing Address - Country:US
Mailing Address - Phone:248-628-5750
Mailing Address - Fax:248-628-4183
Practice Address - Street 1:950 S LAPEER RD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MI
Practice Address - Zip Code:48371-5041
Practice Address - Country:US
Practice Address - Phone:248-628-5750
Practice Address - Fax:248-628-4183
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010156931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice