| Cle Oms Lakewood/rocky River - Jeffrey W. Kosman Dds Inc. | |
|
15711 Madison Ave Suite 104 Lakewood OH 44107-5655 | |
| (216) 228-9000 | |
| (216) 228-8280 |
| Full Name | Cle Oms Lakewood/rocky River - Jeffrey W. Kosman Dds Inc. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 15711 Madison Ave, Lakewood, Ohio |
| Authorized Official Name and Position | Jeffrey W. Kosman (OWNER) |
| Authorized Official Contact | 4409342626 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cle Oms Lakewood/rocky River - Jeffrey W. Kosman Dds Inc. 15711 Madison Ave Suite 104 Lakewood OH 44107-5655 Ph: (216) 228-9000 | Cle Oms Lakewood/rocky River - Jeffrey W. Kosman Dds Inc. 15711 Madison Ave Suite 104 Lakewood OH 44107-5655 Ph: (216) 228-9000 |
| NPI Number | 1083153985 |
|---|---|
| Provider Enumeration Date | 02/13/2017 |
| Last Update Date | 02/13/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083153985 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 30020221 (Ohio) | Primary |
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