| 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 - Oral And Maxillofacial Surgery |
| Location | 9601 Chester Ave, Cleveland, Ohio |
| Authorized Official Name and Position | Dale A. Baur (DEPARTMENT CHAIR) |
| Authorized Official Contact | 2163683102 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| 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 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104059658 | NPI | - | NPPES |
| 301960 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (Ohio) | Primary |
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