Provider Demographics
NPI:1417554205
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:
Authorized Official - Phone:740-587-4891
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:614-425-9059
Mailing Address - Fax:
Practice Address - Street 1:1718 W HIGH ST
Practice Address - Street 2:
Practice Address - City:PIQUA
Practice Address - State:OH
Practice Address - Zip Code:45356-9325
Practice Address - Country:US
Practice Address - Phone:937-862-0173
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:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental