Provider Demographics
NPI:1952893018
Name:FAMILY DENTAL PIQUA-M. ALEXANDRUNAS, DMD, INC
Entity Type:Organization
Organization Name:FAMILY DENTAL PIQUA-M. ALEXANDRUNAS, DMD, INC
Other - Org Name:PREMIER DENTAL OF PIQUA
Other - Org Type:Other Name
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDRUNAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-425-9059
Mailing Address - Street 1:1718 W HIGH ST
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-9325
Mailing Address - Country:US
Mailing Address - Phone:937-773-8090
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?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-05
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental