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General NPI Number Information
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NPI Number | 1386203396
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Entity Type | Organization
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Legal Business Name | SIDNEY FAMILY DENTAL
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Dates
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Enumeration Date | 06/12/2019
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Last Update Date | 06/12/2019
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Provider Practice Location Address
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Address Line | 325 2ND AVE
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City | SIDNEY
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State | OH
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Zip | 45365-1262
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Country | US
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Telephone | 937-492-1790
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Fax |
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Provider Business Mailing Address
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Address Line | 9685 HARDING HWY
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City | HARROD
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State | OH
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Zip | 45850-9424
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Country | US
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Telephone | 419-230-6535
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BEN WARNOCK
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Credential | DDS
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Telephone | 419-230-6535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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