Provider Demographics
NPI:1376157263
Name:M ALEXANDRUNAS D HUDOBA DENTAL 1 INC
Entity Type:Organization
Organization Name:M ALEXANDRUNAS D HUDOBA DENTAL 1 INC
Other - Org Name:PREMIER DENTAL OF DUBLIN
Other - Org Type:Doing Business As
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:614-425-9061
Mailing Address - Street 1:PO BOX 822
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-0822
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:365 W BRIDGE ST
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-2124
Practice Address - Country:US
Practice Address - Phone:614-588-0491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental