Provider Demographics
NPI:1861644452
Name:WAYNE T. MAHAR JR. DDS INC.
Entity Type:Organization
Organization Name:WAYNE T. MAHAR JR. DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:T
Authorized Official - Last Name:MAHAR
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:740-392-1871
Mailing Address - Street 1:206 S. MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:MT. VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050
Mailing Address - Country:US
Mailing Address - Phone:740-392-1871
Mailing Address - Fax:740-392-2082
Practice Address - Street 1:206 S. MULBERRY ST
Practice Address - Street 2:
Practice Address - City:MT. VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050
Practice Address - Country:US
Practice Address - Phone:740-392-1871
Practice Address - Fax:740-392-2082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty