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General NPI Number Information
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NPI Number | 1336620251
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Entity Type | Organization
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Legal Business Name | SEAN M MOHN DDS INC
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Dates
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Enumeration Date | 08/28/2018
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Last Update Date | 08/19/2019
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Provider Practice Location Address
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Address Line | 129 W 2ND ST
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City | DOVER
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State | OH
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Zip | 44622-2931
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Country | US
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Telephone | 330-343-8132
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Fax |
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Provider Business Mailing Address
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Address Line | 129 W 2ND ST
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City | DOVER
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State | OH
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Zip | 44622-2931
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Country | US
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Telephone | 330-343-8132
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Fax |
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Authorized Official
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Title or Position | RECEPTION
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Name | CIARA HARSHEY
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Credential |
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Telephone | 330-343-8132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30.020688
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License Number State | OH
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