Provider Demographics
NPI:1548673031
Name:MUSIC, SEAN
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:MUSIC
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45133-0400
Mailing Address - Country:US
Mailing Address - Phone:937-393-1472
Mailing Address - Fax:937-393-4824
Practice Address - Street 1:321 CHILLICOTHE AVE
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-7378
Practice Address - Country:US
Practice Address - Phone:937-393-1472
Practice Address - Fax:937-393-4824
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30024248122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH30024248OtherDENTAL LICENSE