Provider Demographics
NPI:1831560606
Name:SIDNEY DENTAL ASSOCIATES; INC
Entity type:Organization
Organization Name:SIDNEY DENTAL ASSOCIATES; INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ADARSH
Authorized Official - Middle Name:
Authorized Official - Last Name:MANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-492-4598
Mailing Address - Street 1:1465 N VANDEMARK RD
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365-3547
Mailing Address - Country:US
Mailing Address - Phone:937-492-4598
Mailing Address - Fax:
Practice Address - Street 1:1465 N VANDEMARK RD
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365-3547
Practice Address - Country:US
Practice Address - Phone:937-492-4598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.021236122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty