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2460 Fairmount Blvd Cleveland OH 44106-3171 | |
(216) 791-5191 | |
(216) 231-4933 |
Full Name | |
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Speciality | Dentist - Dental Public Health |
Location | 2460 Fairmount Blvd, Cleveland, Ohio |
Authorized Official Name and Position | Amy Dinardo (OFFICE MANAGER) |
Authorized Official Contact | 2167915191 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2460 Fairmount Blvd Suite 218 Cleveland OH 44106-3171 Ph: (216) 791-5191 | 2460 Fairmount Blvd Cleveland OH 44106-3171 Ph: (216) 791-5191 |
NPI Number | 1114376845 |
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Provider Enumeration Date | 06/03/2016 |
Last Update Date | 06/03/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114376845 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223D0001X | Dentist - Dental Public Health | 30015925 (Ohio) | Primary |
1223D0001X | Dentist - Dental Public Health | 20624 (Ohio) | Secondary |
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