| Case Dental Medicine Support Services, Llc. | |
|
9601 Chester Ave Suite 154 Cleveland OH 44106-1666 | |
| (216) 368-3102 | |
| (216) 368-4338 |
| Full Name | Case Dental Medicine Support Services, Llc. |
|---|---|
| Speciality | Dentist |
| Location | 9601 Chester Ave, Cleveland, Ohio |
| Authorized Official Name and Position | Dale A. Baur (DEPARTMENT CHAIR) |
| Authorized Official Contact | 2163683102 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Case Dental Medicine Support Services, Llc. P.o. Box 415 Chesterland OH 44026-0415 Ph: (440) 729-3399 | Case Dental Medicine Support Services, Llc. 9601 Chester Ave Suite 154 Cleveland OH 44106-1666 Ph: (216) 368-3102 |
| NPI Number | 1104059658 |
|---|---|
| Provider Enumeration Date | 09/01/2009 |
| Last Update Date | 06/22/2021 |
| Medicare PECOS PAC ID | 7416071592 |
|---|---|
| Medicare Enrollment ID | O20100825001171 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104059658 | NPI | - | NPPES |
| 301960 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (Ohio) | Primary |
| Provider Name | Dale A Baur |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1245218544 PECOS PAC ID: 0143312652 Enrollment ID: I20070828000581 |
| Provider Name | Faisal A Quereshy |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1144316126 PECOS PAC ID: 0840467551 Enrollment ID: I20120120000626 |
| Provider Name | Keith M Schneider |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1841451697 PECOS PAC ID: 6406010842 Enrollment ID: I20120614000325 |
| Provider Name | Marie Grosh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497145601 PECOS PAC ID: 1153647565 Enrollment ID: I20150302002515 |
| Provider Name | Milda Chmieliauskaite |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1720493265 PECOS PAC ID: 1658641766 Enrollment ID: I20170724000599 |
| Provider Name | Jaclyn A Tomsic |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1326224783 PECOS PAC ID: 4284852369 Enrollment ID: I20191115001828 |
| Provider Name | Joseph I Helman |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1285732909 PECOS PAC ID: 3779549092 Enrollment ID: I20201020000135 |
| Provider Name | Juan Martin Palomo |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1508277930 PECOS PAC ID: 3870949753 Enrollment ID: I20231030000524 |
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