Provider Demographics
NPI:1174393060
Name:MIAMI VALLEY ORAL SURGERY AND DENTAL IMPLANTS LLC
Entity type:Organization
Organization Name:MIAMI VALLEY ORAL SURGERY AND DENTAL IMPLANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EMPLOYEE
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:CUDNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:269-615-6987
Mailing Address - Street 1:3585 WENDLETON LN
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45432-2753
Mailing Address - Country:US
Mailing Address - Phone:937-426-8083
Mailing Address - Fax:937-426-2818
Practice Address - Street 1:3585 WENDLETON LN
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45432-2753
Practice Address - Country:US
Practice Address - Phone:937-426-8083
Practice Address - Fax:937-426-2818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty