Provider Demographics
NPI:1336620251
Name:SEAN M MOHN DDS INC
Entity Type:Organization
Organization Name:SEAN M MOHN DDS INC
Other - Org Name:DOVER DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RECEPTION
Authorized Official - Prefix:
Authorized Official - First Name:CIARA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARSHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-343-8132
Mailing Address - Street 1:129 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44622-2931
Mailing Address - Country:US
Mailing Address - Phone:330-343-8132
Mailing Address - Fax:
Practice Address - Street 1:129 W 2ND ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-2931
Practice Address - Country:US
Practice Address - Phone:330-343-8132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEAN MOHN DDS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-28
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.020688122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty