Provider Demographics
NPI:1578399465
Name:MOLNAR & LEE ORAL FACIAL SURGERY AND DENTAL IMPLANT CENTER, LLC
Entity type:Organization
Organization Name:MOLNAR & LEE ORAL FACIAL SURGERY AND DENTAL IMPLANT CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-439-5901
Mailing Address - Street 1:2191 PARK AVE W
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OH
Mailing Address - Zip Code:44906-1226
Mailing Address - Country:US
Mailing Address - Phone:419-529-9494
Mailing Address - Fax:
Practice Address - Street 1:2191 PARK AVE W
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OH
Practice Address - Zip Code:44906-1226
Practice Address - Country:US
Practice Address - Phone:419-529-9494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty